Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Physical activity for antenatal and postnatal depression in women attempting to quit smoking: randomised controlled trial

Authors: Amanda Daley, Muhammad Riaz, Sarah Lewis, Paul Aveyard, Tim Coleman, Isaac Manyonda, Robert West, Beth Lewis, Bess Marcus, Adrian Taylor, Judith Ibison, Andrew Kent, Michael Ussher

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

Login to get access

Abstract

Background

Antenatal depression is associated with harmful consequences for both the mother and child. One intervention that might be effective is participation in regular physical activity although data on this question in pregnant smokers is currently lacking.

Methods

Women were randomised to six-weekly sessions of smoking cessation behavioural-support, or to the same support plus 14 sessions combining treadmill exercise and physical activity consultations.

Results

Among 784 participants (mean gestation 16-weeks), EPDS was significantly higher in the physical activity group versus usual care at end-of-pregnancy (mean group difference (95% confidence intervals (CIs)): 0.95 (0.08 to 1.83). There was no significant difference at six-months postpartum.

Conclusion

A pragmatic intervention to increase physical activity in pregnant smokers did not prevent depression at end-of-pregnancy or at six-months postpartum. More effective physical activity interventions are needed in this population.

Trial registration

Current Controlled Trials ISRCTN48600346. The trial was prospectively registered on 21/07/2008.
Literature
1.
go back to reference Banti S, Mauri M, Oppo A, Borri C, Rambelli C, Ramacciotti D, et al. From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Results from the Perinatal Depression–Research & Screening Unit study. Compr Psychiatry. 2011;52:343–51.CrossRefPubMed Banti S, Mauri M, Oppo A, Borri C, Rambelli C, Ramacciotti D, et al. From the third month of pregnancy to 1 year postpartum. Prevalence, incidence, recurrence, and new onset of depression. Results from the Perinatal Depression–Research & Screening Unit study. Compr Psychiatry. 2011;52:343–51.CrossRefPubMed
2.
go back to reference Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol. 2004;103:698–709.CrossRefPubMed Bennett HA, Einarson A, Taddio A, Koren G, Einarson TR. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol. 2004;103:698–709.CrossRefPubMed
3.
go back to reference Li D, Liu L, Odouli R. Presence of depressive symptoms during early pregnancy and the risk of preterm delivery: a prospective cohort study. Hum Reprod. 2009;24:46–53.CrossRef Li D, Liu L, Odouli R. Presence of depressive symptoms during early pregnancy and the risk of preterm delivery: a prospective cohort study. Hum Reprod. 2009;24:46–53.CrossRef
4.
go back to reference Wisner KL, Sit DK, Hanusa BH, Moses-Kolko EL, Bogen DL, Hunker DF, et al. Major depression and antidepressant treatment: impact on pregnancy and neonatal outcomes. Am J Psychiatry. 2009;166:557–66.CrossRefPubMedPubMedCentral Wisner KL, Sit DK, Hanusa BH, Moses-Kolko EL, Bogen DL, Hunker DF, et al. Major depression and antidepressant treatment: impact on pregnancy and neonatal outcomes. Am J Psychiatry. 2009;166:557–66.CrossRefPubMedPubMedCentral
5.
go back to reference Cooper P, Murray L, Wilson A, Romaniuk H. Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression: 1. Impact on maternal mood. Br J Psychiatry. 2003;182:412–9.CrossRefPubMed Cooper P, Murray L, Wilson A, Romaniuk H. Controlled trial of the short- and long-term effect of psychological treatment of post-partum depression: 1. Impact on maternal mood. Br J Psychiatry. 2003;182:412–9.CrossRefPubMed
6.
go back to reference Murray L. The impact of postnatal depression on infant development. J Child Psychol Psychiatry. 1992;33:543–61.CrossRefPubMed Murray L. The impact of postnatal depression on infant development. J Child Psychol Psychiatry. 1992;33:543–61.CrossRefPubMed
7.
go back to reference Kendrick T, Chatwin J, Dowrick C, Tylee A, Morriss R, Peveler R, et al. Randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of selective serotonin reuptake inhibitors plus supportive care, versus supportive care alone, for mild to moderate depression with somatic symptoms in primary care: the THREAD (THREshold for AntiDepressant response) study. Health Technol Assess. 2009;13:22.CrossRef Kendrick T, Chatwin J, Dowrick C, Tylee A, Morriss R, Peveler R, et al. Randomised controlled trial to determine the clinical effectiveness and cost-effectiveness of selective serotonin reuptake inhibitors plus supportive care, versus supportive care alone, for mild to moderate depression with somatic symptoms in primary care: the THREAD (THREshold for AntiDepressant response) study. Health Technol Assess. 2009;13:22.CrossRef
8.
go back to reference Rai D, Lee BK, Dalman C, Golding J, Lewis G, Magnusson C. Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. BMJ. 2013;346:f2059.CrossRefPubMedPubMedCentral Rai D, Lee BK, Dalman C, Golding J, Lewis G, Magnusson C. Parental depression, maternal antidepressant use during pregnancy, and risk of autism spectrum disorders: population based case-control study. BMJ. 2013;346:f2059.CrossRefPubMedPubMedCentral
9.
go back to reference Bower P, Knowles S, Coventry PA, Rowland N. Counselling for mental health and psychosocial problems in primary care. Cochrane Database Syst Rev. 2011;9:CD001025. Bower P, Knowles S, Coventry PA, Rowland N. Counselling for mental health and psychosocial problems in primary care. Cochrane Database Syst Rev. 2011;9:CD001025.
10.
go back to reference American College of Obstetrics and Gynecology. American College of Obstetrics and Gynecology committee opinion. Exercise during pregnancy and the postpartum period. Number 267, January 2002. Int J Gynaecol Obstet. 2002;77:79–81.CrossRef American College of Obstetrics and Gynecology. American College of Obstetrics and Gynecology committee opinion. Exercise during pregnancy and the postpartum period. Number 267, January 2002. Int J Gynaecol Obstet. 2002;77:79–81.CrossRef
11.
go back to reference Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, et al. Exercise for depression. Cochrane Database Syst Rev. 2013;9:CD004366. Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, et al. Exercise for depression. Cochrane Database Syst Rev. 2013;9:CD004366.
12.
14.
go back to reference Daley AJ, Jolly K, MacArthur C. The effectiveness of exercise in the management of postnatal depression: systematic review and meta-analysis. Fam Pract. 2009;26:154–62.CrossRefPubMed Daley AJ, Jolly K, MacArthur C. The effectiveness of exercise in the management of postnatal depression: systematic review and meta-analysis. Fam Pract. 2009;26:154–62.CrossRefPubMed
15.
go back to reference Daley AJ, Foster L, Long G, Palmer C, Robinson O, Walmsley H, et al. The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta-analysis. BJOG. 2015;122:57–62.CrossRefPubMed Daley AJ, Foster L, Long G, Palmer C, Robinson O, Walmsley H, et al. The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta-analysis. BJOG. 2015;122:57–62.CrossRefPubMed
16.
go back to reference Fontein-Kuipers YJ, Nieuwenhuijze MJ, Ausems M, Budé L, de Vries R. Antenatal interventions to reduce maternal distress: a systematic review and meta-analysis of randomised trials. BJOG. 2014;121:389–97.CrossRefPubMed Fontein-Kuipers YJ, Nieuwenhuijze MJ, Ausems M, Budé L, de Vries R. Antenatal interventions to reduce maternal distress: a systematic review and meta-analysis of randomised trials. BJOG. 2014;121:389–97.CrossRefPubMed
17.
go back to reference Songøygard KM, Stafne SN, Evensen KA, Salvesen KÅ, Vik T, Mørkved S. Does exercise during pregnancy prevent postnatal depression? A randomized controlled trial. Acta Obstet Gynecol Scand. 2012;91:62–7.CrossRefPubMed Songøygard KM, Stafne SN, Evensen KA, Salvesen KÅ, Vik T, Mørkved S. Does exercise during pregnancy prevent postnatal depression? A randomized controlled trial. Acta Obstet Gynecol Scand. 2012;91:62–7.CrossRefPubMed
18.
go back to reference Lewis BA, Gjerdingen D, Avery M, Sirard J, Guo H, Schuver K, et al. A randomized trial examining a physical activity intervention for the prevention of postpartum depression: the healthy mom trial. Ment Health Phys Activ. 2014;7:42–9.CrossRef Lewis BA, Gjerdingen D, Avery M, Sirard J, Guo H, Schuver K, et al. A randomized trial examining a physical activity intervention for the prevention of postpartum depression: the healthy mom trial. Ment Health Phys Activ. 2014;7:42–9.CrossRef
19.
go back to reference Perales M, Refoyo I, Coteron J, Bacchi M, Barakat R. Exercise during pregnancy attenuates prenatal depression: a randomized controlled trial. Eval Health Prof. 2015;38:59–72.CrossRefPubMed Perales M, Refoyo I, Coteron J, Bacchi M, Barakat R. Exercise during pregnancy attenuates prenatal depression: a randomized controlled trial. Eval Health Prof. 2015;38:59–72.CrossRefPubMed
20.
go back to reference Daley AJ, Blamey RV, Jolly K, Roalfe A, Turner K, Coleman S, et al. A pragmatic randomised controlled trial to evaluate the effectiveness of a facilitated exercise intervention as a treatment for postnatal depression: the PAM-PeRS trial. Psychol Med. 2015;45:2413–25.CrossRefPubMed Daley AJ, Blamey RV, Jolly K, Roalfe A, Turner K, Coleman S, et al. A pragmatic randomised controlled trial to evaluate the effectiveness of a facilitated exercise intervention as a treatment for postnatal depression: the PAM-PeRS trial. Psychol Med. 2015;45:2413–25.CrossRefPubMed
21.
go back to reference Ussher M, Aveyard P, Manyonda I, Lewis S, West R, Lewis B, et al. Physical activity as an aid to smoking cessation during pregnancy (LEAP) trial: study protocol for a randomized controlled trial. Trials. 2012;13:186.CrossRefPubMedPubMedCentral Ussher M, Aveyard P, Manyonda I, Lewis S, West R, Lewis B, et al. Physical activity as an aid to smoking cessation during pregnancy (LEAP) trial: study protocol for a randomized controlled trial. Trials. 2012;13:186.CrossRefPubMedPubMedCentral
22.
go back to reference Haasova M, Warren FC, Ussher M, et al. The acute effects of physical activity on cigarette cravings: systematic review and meta-analysis with individual participant data (IPD). Addiction. 2012;108:26–37.CrossRefPubMed Haasova M, Warren FC, Ussher M, et al. The acute effects of physical activity on cigarette cravings: systematic review and meta-analysis with individual participant data (IPD). Addiction. 2012;108:26–37.CrossRefPubMed
23.
go back to reference Prapavessis H, De Jesus S, Harper T, Cramp A, Fitzgeorge L, Mottola M, Ussher M, Faulkner G, Selby P. The effects of acute exercise on cravings and withdrawal symptoms in temporary abstinent pregnant smokers. Addict Behav. 2014;39:703–8.CrossRefPubMed Prapavessis H, De Jesus S, Harper T, Cramp A, Fitzgeorge L, Mottola M, Ussher M, Faulkner G, Selby P. The effects of acute exercise on cravings and withdrawal symptoms in temporary abstinent pregnant smokers. Addict Behav. 2014;39:703–8.CrossRefPubMed
24.
go back to reference Ussher M, Lewis S, Aveyard P, Manyonda I, West R, Lewis B, Marcus B, Riaz M, Taylor A, Daley A, Coleman T. Physical activity for smoking cessation in pregnancy: randomised controlled trial. BMJ. 2015;350:h2145.CrossRefPubMedPubMedCentral Ussher M, Lewis S, Aveyard P, Manyonda I, West R, Lewis B, Marcus B, Riaz M, Taylor A, Daley A, Coleman T. Physical activity for smoking cessation in pregnancy: randomised controlled trial. BMJ. 2015;350:h2145.CrossRefPubMedPubMedCentral
25.
go back to reference NHS Information Centre. Infant feeding survey 2010: early results. Leeds: National Health Service Information Centre for Health and Social Care; 2011. NHS Information Centre. Infant feeding survey 2010: early results. Leeds: National Health Service Information Centre for Health and Social Care; 2011.
26.
go back to reference Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002-2010 in Finland. BMJ Open. 2014;4(11):e004883.CrossRefPubMedPubMedCentral Räisänen S, Lehto SM, Nielsen HS, Gissler M, Kramer MR, Heinonen S. Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002-2010 in Finland. BMJ Open. 2014;4(11):e004883.CrossRefPubMedPubMedCentral
27.
go back to reference Prochaska JJ, Hall SM, Humfleet G, Munoz RF, Reus V, Gorecki J, Hu D. Physical activity as a strategy for maintaining tobacco abstinence: a randomized trial. Prev Med. 2008;47:215–20.CrossRefPubMedPubMedCentral Prochaska JJ, Hall SM, Humfleet G, Munoz RF, Reus V, Gorecki J, Hu D. Physical activity as a strategy for maintaining tobacco abstinence: a randomized trial. Prev Med. 2008;47:215–20.CrossRefPubMedPubMedCentral
28.
go back to reference Fagerström K. Determinants of tobacco use and renaming the FTND to the Fagerstrom test for cigarette dependence. Nicotine Tob Res. 2012;14:75–8.CrossRefPubMed Fagerström K. Determinants of tobacco use and renaming the FTND to the Fagerstrom test for cigarette dependence. Nicotine Tob Res. 2012;14:75–8.CrossRefPubMed
29.
go back to reference Heatherton T, Kozlowski L, Frecker T, Fagerström K. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Brit J Addict. 1991;86:1119–27.CrossRef Heatherton T, Kozlowski L, Frecker T, Fagerström K. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Brit J Addict. 1991;86:1119–27.CrossRef
30.
go back to reference Blair SN, Haskell WL, Ho P, Paffenbarger P, Vranizan KM, Farquhar JW, et al. Assessment of habitual physical activity by seven-day recall in a community survey and controlled experiments. Am J Epidemiol. 1985;122:794–804.CrossRefPubMed Blair SN, Haskell WL, Ho P, Paffenbarger P, Vranizan KM, Farquhar JW, et al. Assessment of habitual physical activity by seven-day recall in a community survey and controlled experiments. Am J Epidemiol. 1985;122:794–804.CrossRefPubMed
31.
go back to reference Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh depression scale (EPDS). J Reprod Infant Psyc. 1990;8:99–107.CrossRef Murray D, Cox JL. Screening for depression during pregnancy with the Edinburgh depression scale (EPDS). J Reprod Infant Psyc. 1990;8:99–107.CrossRef
32.
go back to reference Cox J, Holden J, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Brit J Psychiatry. 1987;150:782–6.CrossRef Cox J, Holden J, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh postnatal depression scale. Brit J Psychiatry. 1987;150:782–6.CrossRef
33.
go back to reference Gibson J, McKenzie-McHarg K, Shakespeare J, Price J, Gray R. A systematic review of studies validating the Edinburgh postnatal depression scale in antepartum and postpartum women. Acta Psychiatr Scand. 2009;119:350–64.CrossRefPubMed Gibson J, McKenzie-McHarg K, Shakespeare J, Price J, Gray R. A systematic review of studies validating the Edinburgh postnatal depression scale in antepartum and postpartum women. Acta Psychiatr Scand. 2009;119:350–64.CrossRefPubMed
34.
go back to reference Matthey S. Calculating clinically significant change in postnatal depression studies using the Edinburgh postnatal depression scale. J Affect Disorders. 2004;78:269–72.CrossRefPubMed Matthey S. Calculating clinically significant change in postnatal depression studies using the Edinburgh postnatal depression scale. J Affect Disorders. 2004;78:269–72.CrossRefPubMed
35.
go back to reference Matthey S, Henshaw C, Elliott S, Barnett B. Variability in use of cut-off scores and formats on the Edinburgh postnatal depression scale – implications for clinical and research practice. Arch Womens Ment Health. 2006;9:309–15.CrossRefPubMed Matthey S, Henshaw C, Elliott S, Barnett B. Variability in use of cut-off scores and formats on the Edinburgh postnatal depression scale – implications for clinical and research practice. Arch Womens Ment Health. 2006;9:309–15.CrossRefPubMed
36.
go back to reference Azur MJ, Stuart EA, Frangakis C, Leaf PJ. Multiple imputation by chained equations: what is it and how does it work? Int J Methods Psychiatr Res. 2011;20:40–9.CrossRefPubMedPubMedCentral Azur MJ, Stuart EA, Frangakis C, Leaf PJ. Multiple imputation by chained equations: what is it and how does it work? Int J Methods Psychiatr Res. 2011;20:40–9.CrossRefPubMedPubMedCentral
37.
go back to reference Rubin DB. Multiple imputation for nonresponse in surveys. New York: Wiley; 1987.CrossRef Rubin DB. Multiple imputation for nonresponse in surveys. New York: Wiley; 1987.CrossRef
38.
go back to reference Fergusson D, Aaron SD, Guyatt G, Hébert P. Post-randomisation exclusions: the intention to treat principle and excluding patients from analysis. BMJ. 2002;325:652–4.CrossRefPubMedPubMedCentral Fergusson D, Aaron SD, Guyatt G, Hébert P. Post-randomisation exclusions: the intention to treat principle and excluding patients from analysis. BMJ. 2002;325:652–4.CrossRefPubMedPubMedCentral
39.
go back to reference Chalder M, Wiles NJ, Campbell J, Hollinghurst SP, Haase AM, Taylor AH, et al. Facilitated physical activity as a treatment for depressed adults: randomised controlled trial. BMJ. 2012;344:e2758.CrossRefPubMedPubMedCentral Chalder M, Wiles NJ, Campbell J, Hollinghurst SP, Haase AM, Taylor AH, et al. Facilitated physical activity as a treatment for depressed adults: randomised controlled trial. BMJ. 2012;344:e2758.CrossRefPubMedPubMedCentral
40.
go back to reference Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106:1071–83.CrossRefPubMed Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106:1071–83.CrossRefPubMed
42.
go back to reference Affonso DD, De AK, Horowitz JA, Mayberry LJ. An international study exploring levels of postpartum depressive symptomatology. J Psychosom Res. 2000;49:207–16.CrossRefPubMed Affonso DD, De AK, Horowitz JA, Mayberry LJ. An international study exploring levels of postpartum depressive symptomatology. J Psychosom Res. 2000;49:207–16.CrossRefPubMed
Metadata
Title
Physical activity for antenatal and postnatal depression in women attempting to quit smoking: randomised controlled trial
Authors
Amanda Daley
Muhammad Riaz
Sarah Lewis
Paul Aveyard
Tim Coleman
Isaac Manyonda
Robert West
Beth Lewis
Bess Marcus
Adrian Taylor
Judith Ibison
Andrew Kent
Michael Ussher
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1784-3

Other articles of this Issue 1/2018

BMC Pregnancy and Childbirth 1/2018 Go to the issue