The impact of physical exercise in pregnancy on the development of postnatal depression
An integrative literature review
DOI:
https://doi.org/10.14528/snr.2025.59.1.3262Keywords:
birth, depression, exercise intervention, physiotherapy, health educationAbstract
Introduction: New situations such as childbirth are physically and psychologically stressful, especially if accompanied by postnatal depression, the most common postnatal mental disorder with possible long-term effects. The aim of this integrative literature review is to examine the effects of exercise interventions during pregnancy on the development of postnatal depression and to determine whether all exercise interventions are equally efficient.
Methods: A systematic search of two electronic databases was conducted and included studies of women who had undergone an exercise intervention during pregnancy. From the 451 identified hits, four randomised controlled studies published between 2015 and 2022 were included in the final analysis. This review was conducted and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, and the Mixed Methods Appraisal Tool (MMAT) was used to assess methodological quality.
Results: Two of the four studies included in this review reported that exercise interventions reduce the development of postnatal depression. All studies claim that modern intervention approaches are needed.
Discussion and conclusion: The results of this integrative literature review cannot fully confirm whether exercise intervention in pregnancy can effectively reduce the development of postnatal depression. The limitations of this review along with the scarcity of relevant studies call for further research in this field. Nevertheless, physical activity in pregnant women should be encouraged by physiotherapists and other health professionals.
Downloads
Metrics
References
Aguilar-Cordero, M. J., Sanchez-Garcia, J. C., Rodriguez- Blanque, R., Sanchez-Lopez, A. M., & Mur-Villar, N. (2019). Moderate physical activity in an aquatic environment during pregnancy (SWEP Study) and its influence in preventing postpartum depression. Journal of the American Psychiatric Nurses Association, 25(2), 112–121. https://doi.org/10.1177/1078390317753675 PMid:29490560
Coll, C. V. N., Domingues, M. R., Stein, A., da Silva, B. G. C., Bassani, D. G., Hartwig, F. P., Crochemore Mohnsan da Silva, I., Freitas da Silveira, M., Ginar da Silva, S., & Damaso Bertoldi, A. (2019). Efficacy of regular exercise during pregnancy on the prevention of postpartum depression: The PAMELA randomized clinical trial. JAMA Network Open, 2(1), Article e186861. https://doi.org/10.1001/jamanetworkopen.2018.6861 PMid:30646198; PMCid:PMC6324311
Davenport, M. H., McCurdy, A. P., Mottola, M. F., Skow, R. J., Meah, V. L., Poitras, V. J., Jaramillo Garcia, A., Gray, C. E., Barrowman, N., Riske, L., Sobierajski, F., James, M., Nagpal, T., Marchand, A.-A., Nuspl, M., Slater, L. G., Barakat, R., Adamo, K. B., Davies, G. A., & Ruchat, S.-M. (2018). Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: A systematic review and meta-analysis. British Journal of Sports Medicine, 52(21), 1376–1385. https://doi.org/10.1136/bjsports-2018-099697 PMid:30337464
Elbaz Braun, A., Solt, I., & Constantini, N. (2023). Physical activity during pregnancy and after birth. Harefuah, 162(3), 146–151. https://pubmed.ncbi.nlm.nih.gov/36966370/
Flor-Alemany, M., Migueles, J. H., Alemany-Arrebola, I., Aparicio, V. A., & Baena-Garcia, L. (2022). Exercise, mediterranean diet adherence or both during pregnancy to prevent postpartum depression-GESTAFIT trial secondary analyses. International Journal of Environmental Research and Public Health, 19(21), Article 14450. https://doi.org/10.3390/ijerph192114450 PMid:36361335; PMCid:PMC9657805
Hong, Q. N., Pluye, P., Fabregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., Nicolau, B., O'Cathain, A., Rousseau, M.-C., & Vedel, I. (2023, March 30). Mixed methods appraisal tool (MMAT) version 2018: User guide. McGill University. http://mixedmethodsappraisaltoolpublic. pbworks.com/w/file/fetch/127916259/MMAT_2018_criteriamanual_ 2018-08-01_ENG.pdf.
Howard, K., Maples J. M., & Rachel A. T. (2022). Modifiable maternal factors and their relationship to postpartum depression. International Journal of Environmental Research and Public Health, 19(19), Article 12393. https://doi.org/10.3390/ijerph191912393 PMid:36231692; PMCid:PMC9564437
Jeralic, K., Petrocnik, P., Mekis, N., & Mivsek, A. P. (2022). Maternal and fetal response on prenatal exercise: An quasi experimental pilot study. Kinesiologia Slovenica, 28(3), 69–85. https://doi.org/10.52165/kinsi.28.3.69-85
Khalifa, E., El-Sateh, A., Zeeneldin, M., Abdelghany, A. M., Hosni, M., Abdallah, A., Salama, S., Abdel-Rasheed, M., & Mohammad, H. (2021). Effect of maternal BMI on labor outcomes in primigravida pregnant women. Pregnancy and Childbirth, 21(1), Article 753. https://doi.org/10.1186/s12884-021-04236-z PMid:34749684; PMCid:PMC8574020
Kim, H. B., & Hyun, A. H. (2022). Psychological and biochemical effects of an online pilates intervention in pregnant women during COVID-19: A randomized pilot study. International Journal of Environmental Research and Public Health, 19(17), Article 10931. https://doi.org/10.3390/ijerph191710931 PMid:36078648; PMCid:PMC9517892
Kołomanska, D., Zarawski, M., & Mazur-Bialy, A. (2019). Physical activity and depressive disorders in pregnant women: A systematic review. Medicina, 55(5), Article 212. https://doi.org/10.3390/medicina55050212 PMid:31130705; PMCid:PMC6572339
Kordež, B. (2022). Pojavnost bolečine v spodnjem delu hrbta in/ali bolečine v medeničnem obroču in zadovoljstvo s programom varna vadba v nosečnosti [magistrsko delo, Univerza na Primorskem]. https://repozitorij.upr.si/Dokument.php?id=27244&lang=slv
Lewis, B. A., Schuver, K., Dunsiger, S., Samson, L., Frayeh, A. L., Terrell, C. A., Ciccolo, J. T., Fischer, J., & Avery, M. D. (2021). Randomized trial examining the effect of exercise and wellness interventions on preventing postpartum depression and perceived stress. BMC Pregnancy and Childbirth, 21(1), Article 785. https://doi.org/10.1186/s12884-021-04257-8 PMid:34802425; PMCid:PMC8607568
Lewis, B. A., & Kennedy, B. A. (2011). Effects of exercise on depression during pregnancy and postpartum: A review. American Journal of Lifestyle Medicine, 5(4), 370–378. https://doi.org/10.1177/1559827610392891
Lubbe, W., Van der Walt, C. S., & Klopper, H. C. (2012). Integrative literature review defining evidence-based neurodevelopmental supportive care of the preterm infant. The Journal of Perinatal and Neonatal Nursing, 26(3), 251–259. https://doi.org/10.1097/JPN.0b013e3182650b7e PMid:22843007
Marconcin, P., Peralta, M., Gouveia, E. R., Ferrari, G., Carraca, E., Ihle, A., & Marques, A. (2021). Effects of exercise during pregnancy on postpartum depression: A systematic review of meta-analyses. Biology, 10(12), Article 1331. https://doi.org/10.3390/biology10121331 PMid:34943246; PMCid:PMC8698776
Martinez-Paredes, J. F., & Jacome-Perez, N. (2019). Depression in pregnancy. Revista Colombiana de Psiquiatria (English ed.), 48(1), 58–65. https://doi.org/10.1016/j.rcp.2017.07.003 PMid:30651174
Matthey, S., Henshaw, C., Elliott, S., & Barnett, B. (2006). Variability in use of cut-off scores and formats on the Edinburgh Postnatal Depression Scale: Implications for clinical and research practice. Archives of Women's Mental Health, 9, 309–315. https://doi.org/10.1007/s00737-006-0152-x PMid:17013761
Mohammadi, F., Malakooti, J., Babapoor, J., & Mohammad- Alizadeh-Charandabi, S. (2015). The effect of a home-based exercise intervention on postnatal depression and fatigue: A randomized controlled trial. International Journal of Nursing Practice, 21(5), 478–485. https://doi.org/10.1111/ijn.12259 PMid:24620734
Nakamura, A., Van der Waerden, J., Melchior, M., Bolze, C., El-Khoury, F., & Pryor, L. (2019). Physical activity during pregnancy and postpartum depression: Systematic review and meta-analysis. Journal of Affective Disorders, 246, 29–41. https://doi.org/10.1016/j.jad.2018.12.009 PMid:30576955
Navas, A., Carrascosa, M. del C., Artigues, C., Ortas, S., Portells, E., Soler, A., Yanez, A. M., Bennasar-Veny, M., & Leiva, A. (2021). Journal of Clinical Medicine, 10(11), Article 2432. https://doi.org/10.3390/jcm10112432 PMid:34070842; PMCid:PMC8198819
Nacionalni inštitut za javno zdravje (NIJZ). (2023, November 17). Poporodna depresija in tesnoba. https://nijz.si/zivljenjskislog/ dusevno-zdravje/poporodna-depresija-in-tesnoba/ Nacionalni inštitut za javno zdravje (NIJZ). (2024, November 21). Navodilo za izvajanje, beleženje in obračunavanje storitev v patronažnem varstvu. https://nijz.si/sistem-zdravstvenegavarstva/ patronazno-varstvo/navodilo-za-izvajanje-belezenjein- obracunavanje-storitev-v-patronaznem-varstvu/
Ozkan, S. A., Kucukkelepce, D. S., Korkmaz, B., Yılmaz, G., & Bozkurt, M. A. (2020). The effectiveness of an exercise intervention in reducing the severity of postpartum depression: A randomized controlled trial. Perspectives in Psychiatric Care, 56(4), 844–850. https://doi.org/10.1111/ppc.12500 PMid:32187390
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., hamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hrobjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo- Wilson, E., McDonald, S., ... Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. British Medical Journal, 372, Article 71. https://doi.org/10.1136/bmj.n71 PMid:33782057; PMCid:PMC8005924
Pluye, P., & Hong, Q. N. (2014). Combining the power of stories and the power of numbers: Mixed methods research and mixed studies reviews. Annual Review of Public Health, 35, 29–45. https://doi.org/10.1146/annurev-publhealth-032013-182440 Pravilnik za izvajanje preventivnega zdravstvenega varstva na primarni ravni. (1998). Uradni list RS, št. 19/98, 47/98, 26/00, 67/01, 33/02, 37/03, 117/04, 31/05, 83/07, 22/09, 17/15, 47/18, 57/18, 57/18, 57/21, 162/21, 39/23, 93/23, 125/23, 18/24 in 53/24. NAVO59. https://pisrs.si/pregledPredpisa?id=NAVO59
Riesco-Gonzalez, F. J., Antunez-Calvente, I., Vazquez-Lara, J. M., Rodriguez-Diaz, L., Palomo-Gomez, R., Gomez-Salgado, J., Garcia-Iglesias, J. J., Parron-Carreno, T., & Fernandez- Carrasco, F. J. (2022). Body image dissatisfaction as a risk factor for postpartum depression. Medicina, 58(6), Article 752. https://doi.org/10.3390/medicina58060752 PMid:35744015; PMCid:PMC9228492
Songoygard, K. M., Stafne, S. N., Evensen, K. A. I., Salvesen, K. A., Vik, T., & Morkved, S. (2012). Does exercise during pregnancy prevent postnatal depression: A randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica, 91(1), 62–67. https://doi.org/10.1111/j.1600-0412.2011.01262.x PMid:21880023
Stewart, D. E., & Vigod, S. (2016). Postpartum Depression. New England Journal of Medicine, 375(22), 2177–2186. https://doi.org/10.1056/NEJMcp1607649 PMid:27959754
Videmšek, M., Bokal Vrtačnik, E., Šćepanović, D., Žgur, L., Videmšek, N., Meško, M., Karpljuk, D., Štihec, J., & Hadžić, V. (2015). Priporočila za telesno dejavnost nosečnic. Zdravniški vestnik, 84 (2), 87–98. https://doi.org/10.6016/ZdravVestn.1220
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Slovenian Nursing Review
This work is licensed under a Creative Commons Attribution 4.0 International License.
As the author undersigned hereby, I transfer, assign, or otherwise convey the following authorship rights as comprised in the Copyright and Related Rights Act (CRRA) to the Slovenian Nursing Review, Ob železnici 30A, 1000 Ljubljana: the right of reproduction - the exclusive right to fix the work in a material medium or in another copy directly or indirectly, temporarily or permanently, by any means and in any digital form, in whole or in part (CRRA, Article 23); the right of distribution (CRRA, Article 24); the right of making a work available and accessible through the internet (CRRA, Article 32a); the right of transformation, especially the exclusive right to translate a pre-existing work (CRRA, Article 33). The transfer of author rights applies to the article in its entirety, including pictorial and/or graphic works and possible supplements. The transfer of rights is exclusive and unlimited in duration or territory.
