Skip to main content
Top

07-11-2024 | Anxiety | Review Article

Prenatal exercise and its effects on postpartum mental health: systematic review and meta-analysis

Authors: Lauren E. Hicks, Michelle D. Graf, SeonAe Yeo

Published in: Archives of Women's Mental Health

Login to get access

Abstract

Purpose

The perinatal period, spanning from pregnancy through the first year after childbirth, is characterized by significant physiological, psychological, and socio-contextual changes. Women face complex stressors including psychosocial pressures, financial constraints, interpersonal dynamics, anticipatory stress related to parenthood, hormonal fluctuations, and societal expectations. These factors collectively influence the perinatal experience, increasing vulnerabilities and stress levels.

Methods

A systematic review was conducted in October 2023 using PubMed, SPORTDiscus, PsycInfo, and Scopus databases. Only English-language publications were included. For the meta-analysis, only randomized controlled trials (RCTs) using the Edinburgh Postnatal Depression Scale (EPDS) were considered. Data extraction was performed independently by two reviewers using Covidence, focusing on study characteristics, population demographics, interventions, and outcomes.

Results

The initial search identified 2,373 articles, with 1,196 duplicates removed, leaving 1,177 articles. After screening titles and abstracts, 1,247 were excluded for not meeting the inclusion criteria, resulting in 30 full-text articles reviewed for eligibility by two researchers. Nineteen studies were included in the systematic review, with four in the meta-analysis. Results indicated that higher levels of physical activity during pregnancy were consistently associated with improved postpartum mental health outcomes, including reduced depressive symptoms, lower anxiety, and enhanced overall well-being. Low-intensity exercises, such as yoga, were particularly effective in reducing postpartum depressive symptoms. The impact of moderate-intensity exercise varied, with some studies showing no significant effects. The meta-analysis of four RCTs using the EPDS demonstrated a significant reduction in depression and anxiety symptoms among postpartum women who participated in physical activity interventions, with a substantial overall effect size.

Conclusion

Developing physical activity and exercise regimens encompassing a range of intensities can address the unique physiological and psychological demands of the perinatal period, maximizing the therapeutic benefits of physical activity interventions.
Literature
go back to reference Ana Y, Lewis MG, van Schayck OCP, Babu GR (2021) Is physical activity in pregnancy associated with prenatal and postnatal depressive symptoms? Results from MAASTHI cohort study in South India. J Psychosom Res 144:110390CrossRefPubMedPubMedCentral Ana Y, Lewis MG, van Schayck OCP, Babu GR (2021) Is physical activity in pregnancy associated with prenatal and postnatal depressive symptoms? Results from MAASTHI cohort study in South India. J Psychosom Res 144:110390CrossRefPubMedPubMedCentral
go back to reference Boisseau N (2022) Physical activity during the perinatal period: Guidelines for interventions during the perinatal period from the French National College of Midwives. J Midwifery Womens Health 6:S158–S171. Boisseau N (2022) Physical activity during the perinatal period: Guidelines for interventions during the perinatal period from the French National College of Midwives. J Midwifery Womens Health 6:S158–S171.
go back to reference Campolong K, Jenkins S, Clark MM, Borowski K, Nelson N, Moore KM, Bobo WV (2018) The association of exercise during pregnancy with trimester-specific and postpartum quality of life and depressive symptoms in a cohort of healthy pregnant women. Arch Womens Ment Health 21:215–224PubMed Campolong K, Jenkins S, Clark MM, Borowski K, Nelson N, Moore KM, Bobo WV (2018) The association of exercise during pregnancy with trimester-specific and postpartum quality of life and depressive symptoms in a cohort of healthy pregnant women. Arch Womens Ment Health 21:215–224PubMed
go back to reference Haßdenteufel K, Feißt M, Brusniak K, Lingenfelder K, Matthies LM, Wallwiener M, Wallwiener S (2020) Reduction in physical activity significantly increases depression and anxiety in the perinatal period: a longitudinal study based on a self-report digital assessment tool. Arch Gynecol Obstet 302:53–64CrossRefPubMed Haßdenteufel K, Feißt M, Brusniak K, Lingenfelder K, Matthies LM, Wallwiener M, Wallwiener S (2020) Reduction in physical activity significantly increases depression and anxiety in the perinatal period: a longitudinal study based on a self-report digital assessment tool. Arch Gynecol Obstet 302:53–64CrossRefPubMed
go back to reference Kowalska J, Olszowa D, Markowska D, Teplik M, Rymaszewska J (2014) Physical activity and childbirth classes during a pregnancy and the level of perceived stress and depressive symptoms in women after childbirth. Psychiatr Pol 48(5):889–900CrossRefPubMed Kowalska J, Olszowa D, Markowska D, Teplik M, Rymaszewska J (2014) Physical activity and childbirth classes during a pregnancy and the level of perceived stress and depressive symptoms in women after childbirth. Psychiatr Pol 48(5):889–900CrossRefPubMed
go back to reference Mirghafourvand M, Jafarabadi MA, Mohammad-Alizadeh S, Mohammadi A (2016) The relationship between physical activity during pregnancy and postpartum mood primiparous women. J Babol Univ Med Sci 18:35–41 Mirghafourvand M, Jafarabadi MA, Mohammad-Alizadeh S, Mohammadi A (2016) The relationship between physical activity during pregnancy and postpartum mood primiparous women. J Babol Univ Med Sci 18:35–41
go back to reference Mughal R, Azhar Y, Siddiqui W (2022) Postpartum depression. StatPearls Publishing, Treasure Island, FL Mughal R, Azhar Y, Siddiqui W (2022) Postpartum depression. StatPearls Publishing, Treasure Island, FL
go back to reference Shakeel N, Richardsen KR, Martinsen EW, Eberhard-Gran M, Slinning K, Jenum AK (2018) Physical activity in pregnancy and postpartum depressive symptoms in a multiethnic cohort. Journal of Affective Disorders Shakeel N, Richardsen KR, Martinsen EW, Eberhard-Gran M, Slinning K, Jenum AK (2018) Physical activity in pregnancy and postpartum depressive symptoms in a multiethnic cohort. Journal of Affective Disorders
go back to reference van der Waerden J, Nakamura A, Pryor L, Charles MA, El-Khoury F, Dargent-Molina P (2019) Domain-specific physical activity and sedentary behavior during pregnancy and postpartum depression risk in the French EDEN and ELFE cohorts. Prev Med 121:33–39CrossRefPubMed van der Waerden J, Nakamura A, Pryor L, Charles MA, El-Khoury F, Dargent-Molina P (2019) Domain-specific physical activity and sedentary behavior during pregnancy and postpartum depression risk in the French EDEN and ELFE cohorts. Prev Med 121:33–39CrossRefPubMed
go back to reference Watson SJ, Lewis AJ, Boyce P, Galbally M (2018) Exercise frequency and maternal mental health: parallel process modelling across the perinatal period in an Australian pregnancy cohort. J Psychosom Res 111:91–99CrossRefPubMed Watson SJ, Lewis AJ, Boyce P, Galbally M (2018) Exercise frequency and maternal mental health: parallel process modelling across the perinatal period in an Australian pregnancy cohort. J Psychosom Res 111:91–99CrossRefPubMed
Metadata
Title
Prenatal exercise and its effects on postpartum mental health: systematic review and meta-analysis
Authors
Lauren E. Hicks
Michelle D. Graf
SeonAe Yeo
Publication date
07-11-2024
Publisher
Springer Vienna
Published in
Archives of Women's Mental Health
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI
https://doi.org/10.1007/s00737-024-01525-2