Does Exercise During Pregnancy Prevent Postpartum Depression?

By | February 1, 2019

While there is some data to indicate that exercise may improve well-being and diminish symptoms of depression and anxiety, the results have been mixed.  A recent randomized controlled trial has explored the efficacy of exercise during pregnancy for reducing the risk of postpartum depression.

The Physical Activity for Mothers Enrolled in Longitudinal Analysis (PAMELA) Study was nested in the 2015 Pelotas (Brazil) Birth Cohort Study.  A total of 639 pregnant women between 16 and 20 weeks of gestation with no contraindications to exercise (mean age, 27.1 years; mean gestational age, 16.5 weeks) were randomly assigned to the intervention group (n?=?213) or control group (n?=?426). Women assigned to the intervention group participated in a 16-week supervised exercise program which included aerobic and resistance training delivered in 60-minute sessions three times per week.

Postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) 3 months after birth. A score of 12 or greater was defined as screening positive for postpartum depression.

Overall compliance with the exercise program (defined as having attended at least 70% of exercise sessions) was low (40.4%).  There was no statistically significant difference in rates of PPD between the intervention group (12 of 192 [6.3%]) and the control group (36 of 387 [9.3%]) (odds ratio, 0.65; 95% CI, 0.33-1.28).   There was no significant difference in mean EPDS scores between the intervention and control groups.

So the jury is still out with regard to the benefits of exercise for the prevention of PPD.  Obviously low rates of compliance may make it difficult to measure the beneficial effects of the intervention.  This study was also conducted in a general population of healthy women with a normal risk for PPD; the efficacy of an intervention to prevent PPD may be easier to measure when tested in a group of women at higher risk for PPD, such as those women who have had an episode of PPD after a previous pregnancy.  

While we don’t know if regular exercise can reduce the risk of PPD, there are other benefits to exercising during pregnancy.  The American College of Obstetricians and Gynecologists (ACOG) provides helpful information regarding the safety and benefits of exercise during pregnancy.

Ruta Nonacs, MD PhD

 

Efficacy of Regular Exercise During Pregnancy on the Prevention of Postpartum Depression: The PAMELA Randomized Clinical Trial.

Coll CVN, Domingues MR, Stein A, da Silva BGC, Bassani DG, Hartwig FP, da Silva ICM, da Silveira MF, da Silva SG, Bertoldi AD.  JAMA Netw Open. 2019 Jan 4;2(1).  Free Article

MGH Center for Women's Mental Health