Exercise may reduce the risk for major postpartum depression

Key takeaways:

• Exercise interventions lowered the risk for major postpartum disorder by nearly half.
• timing of interventions and amount of exercise accumulated impacted efficacy.

Exercise interventions reduced the risk for postpartum depression and the severity of depression and anxiety in women who recently gave birth, results from a review and meta-analysis in the British Journal of Sports Medicine showed.

However, certain thresholds of exercise over the first 3 months of postpartum may need to be met to ultimately achieve the benefits, study investigators noted.

According to the WHO, 10% of pregnant women and 13% of women who recently gave birth worldwide experience a mental disorder, which is usually depression.

Andy Deprato, from the University of Alberta in Canada, and colleagues pointed out that physical activity like aerobic exercise or resistance training among postpartum people have been linked to improvements in mild to moderate depression but “given the limited evidence on the prevalence or severity of postpartum anxiety, no such conclusions have been reached for these outcomes.”

They added that it is also unknown how exercise’s effects on postpartum depression are impacted by the timing of the mood disorder, which may begin anywhere from a few days to a year after postpartum, according to the Mayo Clinic.

In the systematic review and meta-analysis, the researchers compiled and assessed studies published up to January 2024 that examined the impact of interventions — which included either nothing, education or standard care plus exercise — on anxiety and depression in women within the first 12 months postpartum.

The final analysis included 35 studies (n = 4,072) out of an initial 1,152. Of these, 26 were randomized controlled trials and nine were nonrandomized.

Deprato and colleagues noted that the frequency of exercise interventions lasted 1 to 5 days; the duration of exercise lasted from 15 to 90 minutes a session; and the types of exercise included strength training, stretching, yoga and aerobic exercise.

They found that exercise-only interventions were tied to less severe symptoms of depression (standardized mean difference [SMD] = −0.52; 95% CI, −0.8 to –0.24) and anxiety (SMD = −0.25; 95% CI, −0.43 to −0.08) in participants compared with no exercise.

Additionally, the exercise-only interventions also reduced the risk for developing major postpartum depression by 45% (OR = 0.55; 95% CI, 0.32-0.95) vs. no exercise.

Starting the exercise interventions at or before 12 weeks postpartum was tied to lower severity of depressive symptoms (P < .05), whereas this was not seen for exercise interventions that started later than 12 weeks.

The researchers pointed out that a moderate reduction in depressive symptoms needed an accumulation of at least 80 weekly minutes of moderate intensity exercise like brisk walking, stationary cycling or water aerobics.

Deprato and colleagues acknowledged the study was limited because of “considerable variability” among the tools used to evaluate anxiety and depression outcomes.

They added that it remains unclear how exercise may affect both anxiety and depression in combination.

Still, the researchers concluded that the data can be used to “encourage alternative, safe, accessible and inexpensive postpartum mental health treatment options involving exercise and integrate exercise into evidence-based guidelines to promote postpartum health.”

References:

• Deprato A, et al. Br J Sports Med. 2024;doi:10.1136/bjsports-2024-108478.
• Exercise programs help cut new mums’ ‘baby blues’ severity and major depression risk. Available at: https://bmjgroup.com/exercise-programmes-help-cut-new-mums-baby-blues-severity-and-major-depression-risk. Published Nov. 7, 2024. Accessed Nov. 7, 2024.
• Maternal mental health. Available at: https://www.who.int/teams/mental-health-and-substance-use/promotion-prevention/maternal-mental-health. Accessed Nov. 5, 2024.
• Postpartum depression. Available at: https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617. Accessed Nov. 5, 2024.