The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta‐analysis

Abstract

Background Antenatal depression can have harmful consequences for the mother and fetus. Exercise may be a useful intervention to prevent and treat antenatal depression.Objectives This systematic review aims to establish whether there is sufficient evidence to conclude that exercise is an effective intervention for preventing and treating antenatal depression.Search strategy Searches using electronic databases from MEDLINE, Cochrane Library, CINAHL, EMBASE, AMED and PsycINFO were performed.Selection criteria Randomised controlled trials (RCT) that compared any type of exercise intervention with any comparator in pregnant women were eligible for inclusion.Data collection and analysis Meta-analysis was performed calculating standardised mean differences (SMD).Main results Six trials (seven comparisons) were eligible for inclusion. Meta-analysis showed a significant reduction in depression scores (SMD À0.46, 95% CI À0.87 to À0.05, P = 0.03, I 2 = 68%) for exercise interventions relative to comparator groups.The test for subgroup differences in women who were non-depressed (one trial) (SMD À0.74, 95%CI À1.22 to À0.27, P = 0.002) and depressed (five trials) (SMD À0.41, 95% CI À0.88 to 0.07, P = 0.09) at baseline was not significant (P = 0.32). The test for subgroup differences between aerobic (one trial) and non-aerobic exercise (five trials) was also nonsignificant (P = 0.32).Authors' conclusions We found some evidence that exercise may be effective in treating depression during pregnancy but this conclusion is based on a small number of low-moderate quality trials with significant heterogeneity and wide confidence intervals.

The overweight/obesity - depression links over the life course

“…Thirteen articles [1,9,[51][52][53][54][55][56][57][58][59][60][61] were included for systematic review and meta-analysis. All the included studies were prospective studies that examined the association between depression and obesity, of these, seven studies examined depression leading to obesity [1,9,51,52,54,55,57] and six studies investigated obesity leading to depression [53,56,[58][59][60][61]. Three of the studies presented the longitudinal bidirectional data [1,53,56].…”

“…Adult depression is persistent and commonly recurs across the life course [56,57]. After the first episode of depression, percentage estimates for further episodes do vary greatly and have been reported to range from 40% to 85%, depending upon the sample and measures used [58]. Clinical settings showed that the chronicity of depression varies from between 21% to 37% after one year, and between 60% and 75% after five years of follow-up; but these comprise the most severe, pervasive and recurrent cases [59][60][61].…”

“…Three studies [53,58,59] reported this association for both males and females and three other studies reported data only for females [56,60,61]. Participants were diverse in relation to age, race, ethnicity, social and demographic characteristics, although the majority of females were caucasian.…”

“…The mean age varied from 11 to 15 years and follow-up time from 1 up to 20 years. For BMI at baseline, three studies [53,58,59] relied on self-reported information and the remainder of the studies used measured height and weight [1,56,60,61]. At follow-up, four studies assessed depression using depressive symptoms [53,56,58,61] and the rest of the studies used clinical diagnoses [1,59,60].…”

“…At follow-up, four studies assessed depression using depressive symptoms [53,56,58,61] and the rest of the studies used clinical diagnoses [1,59,60]. All but one of the studies [58] removed the baseline depressed participants to assess the incidence. To assess depressive symptom/disorder a wide range of standard scales were used and considered large set of covariates (range from none to 8) across the studies.…”