'Integrate exercise into evidence-based guidelines to promote postpartum health,' says researchers
New mothers affected by the ‘baby blues’ and potentially at risk of risk of developing major clinical depression gain benefits from attending exercise-only programmes.
That is the message contained in an article written by a team of researchers based in Canada and China that was published in the British Journal of Sports Medicine last week (8 November).
The team members included Margie Davenport, from the Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory at the University of Alberta,
The team, which conducted a pooled data analysis of the evidence, found that mothers need to take at least 80 weekly minutes of moderate intensity exercise – such as brisk walking, water aerobics, stationary cycling, and resistance training with bands, weights, or body weight – to reap the rewards.
Maternal depression and anxiety can affect 'bonding'
Maternal depression and anxiety are relatively common after giving birth. They are associated with reduced self-care and compromised infant caregiving and bonding, which can, in turn, affect the child’s cognitive, emotional, and social development, explain the researchers.
Conventional treatments for depression and anxiety in the first weeks and months after giving birth mostly involve drugs and counselling, which are often associated with, respectively, side effects and poor adherence, and lack of timely access and expense.
Previous research suggests that physical activity is an effective and affordable treatment for depression/anxiety, in general, but it’s not known whether it can reduce the severity of the ‘baby blues’ in the first few weeks after giving birth or lower the risk of major postpartum depression several months later, say Dr Davenport and her fellow researchers.
These findings can be applied to encourage alternative, safe, accessible and inexpensive postpartum mental health treatment options involving exercise and to integrate exercise into evidence-based guidelines to promote postpartum health [Andy Deprato et al]
More than 4,000 participants included in study
To shed further light on this and inform future guidelines, they sought relevant studies published up to January 2024 that compared various interventions, including nothing, education, and standard care with exercise to treat depression and anxiety, 12 weeks after, and within the first 12 months of, giving birth.
In all, 35 unique studies out of an initial haul of 1,152 (26 randomised controlled trials and nine non-randomised interventions), involving 4,072 participants from 14 countries, were included in the systematic review.
The frequency of exercise interventions ranged from one to five days a week, lasting anything from 15-90 minutes a session. They included aerobic exercise, strength training, stretching and yoga – as well as combinations of these.
Study results
Pooled data analysis of the study results showed that compared with no exercise, exercise-only interventions were associated with less severe symptoms of depression and anxiety after giving birth and an almost halving in the odds (45 per cent) of developing major postpartum depression.
Starting the intervention before 12 weeks had elapsed after giving birth was associated with a greater reduction in depressive symptoms than starting it later.
And the greater the exercise volume the greater was the reduction in the severity of depressive symptoms. But the minimum threshold required for achieving a moderate reduction in symptom severity was clocking up at least 80 weekly minutes of moderate intensity exercise, on at least four days of the week.
Caveats and conclusions
The researchers note the considerable variability among the tools used to assess depression and anxiety outcomes in the included studies, and the fact that most of them were carried out in high income countries. Depression and anxiety can also occur together, and it’s not clear how exercise affects this combination, they note.
But the authors conclude: ‘Overall, postpartum exercise reduced the severity of depressive and anxiety symptoms and the odds of postpartum depression,' and starting it within the first three months after giving birth 'has the potential to significantly improve postpartum mental health'.
They add: ‘These findings can be applied to encourage alternative, safe, accessible and inexpensive postpartum mental health treatment options involving exercise and to integrate exercise into evidence-based guidelines to promote postpartum health.’
To access the full version of the article – titled Impact of postpartum physical activity on maternal depression and anxiety: a systematic review and meta-analysis Doi: 10.1136/bjsports-2024-108478 – click
Author: Ian A McMillan
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