Effects of Exercise on Mild-to-Moderate Depressive Symptoms in the Postpartum Period

McCurdy, Ashley; Boulé, Normand G.; Sivak, Allison; Davenport, Margie H.

doi:10.1097/aog.0000000000002053

Cited by 69 publications

(71 citation statements)

References 45 publications

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“…A recent review demonstrated that light to moderate intensity aerobic exercise initiated in the postpartum period improves mild to moderate depressive symptoms and increases the likelihood of resolving mild to moderate depression in the postpartum period compared with standard care 20. It has not been established if prenatal exercise reduces the prevalence and/or severity of depression and anxiety during pregnancy and the postpartum period.…”

Section: Introductionmentioning

confidence: 99%

Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis

et al. 2018

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ObjectiveTo examine the influence of prenatal exercise on depression and anxiety during pregnancy and the postpartum period.DesignSystematic review with random effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the Population (pregnant women without contraindication to exercise), Intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise), Comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and Outcome (prenatal or postnatal depression or anxiety).ResultsA total of 52 studies (n=131 406) were included. ‘Moderate’ quality evidence from randomised controlled trials (RCTs) revealed that exercise-only interventions, but not exercise+cointerventions, reduced the severity of prenatal depressive symptoms (13 RCTs, n=1076; standardised mean difference: −0.38, 95% CI −0.51 to –0.25, I2=10%) and the odds of prenatal depression by 67% (5 RCTs, n=683; OR: 0.33, 95% CI 0.21 to 0.53, I2=0%) compared with no exercise. Prenatal exercise did not alter the odds of postpartum depression or the severity of depressive symptoms, nor anxiety or anxiety symptoms during or following pregnancy. To achieve at least a moderate effect size in the reduction of the severity of prenatal depressive symptoms, pregnant women needed to accumulate at least 644 MET-min/week of exercise (eg, 150 min of moderate intensity exercise, such as brisk walking, water aerobics, stationary cycling, resistance training).Summary/ConclusionsPrenatal exercise reduced the odds and severity of prenatal depression.

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Section: Introductionmentioning

confidence: 99%

Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis

et al. 2018

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“…Engaging in regular exercise and physical activity has been demonstrated as a successful treatment modality for major and minor depression in the general population (4), and the potential benefits of exercise on perinatal depression are beginning to emerge as well. Several systematic reviews and meta-analyses, found evidence that exercise may be effective in reducing depression during both pregnancy (5) and the postpartum (6,7). Outcomes of a recent review, although based on a small number of studies, suggest that physical activity during pregnancy may likewise serve to prevent subsequent PPD (8).…”

Section: Introductionmentioning

confidence: 99%

Domain-specific physical activity and sedentary behavior during pregnancy and postpartum depression risk in the French EDEN and ELFE cohorts

Waerden

Nakamura

Pryor

et al. 2019

Preventive Medicine

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The potential beneficial effects of physical activity during pregnancy on postpartum depressive symptoms (PPD) remain inconclusive. Using data from two prospective French birth cohorts, we aimed to examine the relationship between domain-specific physical activity (including leisure-time sedentary behavior) in pregnancy and the occurrence of postpartum depressive symptoms. Participants of the ELFE cohort (N=15538) completed the Pregnancy Physical Activity Questionnaire (PPAQ), which assesses the following physical activity/sedentary behavior domains: household/caregiving, occupational, sports/exercise, transportation and leisure-time sedentary behavior during the third pregnancy trimester. In the EDEN cohort (n = 1745) women completed the Baecke Questionnaire (BQ) measuring occupational, sports/exercise, and leisure-time/locomotive activity during the first trimester of pregnancy. Depressive symptoms in the first postpartum year were measured using the Edinburgh Postnatal Depression Scale in both cohorts. Associations of physical activity/sedentary behavior with PPD symptoms were determined by logistic regression analysis, with adjustment on potential confounding factors. In the adjusted models, higher levels of household/ caregiving activities (OR=1.10 (95% CI 1.01-1.19) and leisure-time sedentary behavior (OR= 1.16 (95% CI 1.06-1.23)), in the third pregnancy trimester were associated with an increased odds of PPD. No significant associations were found for physical activity domains during the first pregnancy trimester. Higher levels of household and caregiving activities and leisure time sedentary behavior in the last trimester of pregnancy appear to increase the likelihood of postpartum depression. Purpose and context of physical activity should be taken into account when encouraging physical activity as a strategy to help prevent postpartum mental health problems from pregnancy onwards.

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“…The study of the relationship between postnatal depression and exercise using validated tools such as the Edinburgh Postnatal Depression Scale (EPDS) questionnaire (Cox et al, 1987) as a basis for data collection was featured in eight of the papers Cramp and Bray, 2010, Daley et al, 2009, Daley et al, 2015, Drista et al, 2009, Lovell et al, 2015, Norman et al, 2010, McCurdy et al, 2017and Shelton and Lee, 2018. This provided the opportunity to objectively examine the relationship between two parameters; exercise and depression.…”

Section: Study Design and Analysismentioning

confidence: 99%

“…In contrast, Norman et al (2010 used the Positive Affect Balance Scale (PABS) questionnaire as a primary outcome measure, in addition to the EPDS questionnaire. Two papers (Daley et al, 2009 andMcCurdy et al, 2017) added the Hamilton rating for depression (Hamilton, 1960) to the EPDS questionnaire although, there was no discussion about the rationale of the choice of each tool in these papers.…”

Section: Study Design and Analysismentioning

confidence: 99%

What outcomes should be measured to evaluate the benefits of exercise for maternal mental health?

Brenchley

Mancz

2019

Journal of Health Visiting

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The physical and mental health of women antenatally and postnatally has been described as fundamentally important to the development of children and the family. Exercise was proposed as a strategy to support maternal mental health, such as postnatal depression with an emphasis on structured and supervised activities. However, a recent systematic review by Saligheh et al (2017) revealed inconsistencies in the evidence base and could not confirm that exercise reduced symptoms of postnatal depression. This study aims to analyse the current evidence base to determine what outcomes should be measured to evaluate the benefits of exercise to maternal mental health. The research concludes that using a quantitative methodological approach, predominantly using the Edinburgh Postnatal Depression Score as a primary outcome measure, does not appear to capture the effects of exercise on postnatal depression and anxiety. Further research using a qualitative approach is recommended to identify outcomes that should be measured to demonstrate the benefits of exercise to maternal mental health.

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Effects of Exercise on Mild-to-Moderate Depressive Symptoms in the Postpartum Period

Abstract: Light-to-moderate intensity aerobic exercise improves mild-to-moderate depressive symptoms and increases the likelihood that mild-to-moderate depression will resolve.

Cited by 69 publications

References 45 publications

Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis

Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis

Domain-specific physical activity and sedentary behavior during pregnancy and postpartum depression risk in the French EDEN and ELFE cohorts

What outcomes should be measured to evaluate the benefits of exercise for maternal mental health?

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