Physical Activity and the Occurrence of Postnatal Depression-A Systematic Review

Daria Kołomańska-Bogucka, Agnieszka Irena Mazur-Bialy, Daria Kołomańska-Bogucka, Agnieszka Irena Mazur-Bialy

Abstract

Background and Objectives: During pregnancy and the postnatal period many changes occur in a woman's body, both in mental and physical spheres. The birth of a child and a new role-of a mother-can sometimes be associated with numerous negative emotions, uncertainty, fear, anxiety, disgust, depression, or sadness. In the puerperium period, the development of baby blues or postpartum depression may occur. Postpartum depression develops within one month of childbirth and may last up to one year. Depressive disorders that may develop in a young mother affect both her and the newborn's health. That is why it is so important to try to search for factors that could significantly reduce the likelihood of developing depression in this period. The study aims at assessing the relationship between physical activity during pregnancy and puerperium or in the postpartum and the development of postnatal depression. Materials and Methods: A review of the literature was carried out in the Medline-PubMed database. The search terms were "pregnancy" AND "physical activity AND postpartum depression". The study included only English-language publications published in the period 2000-2018. Results: A total of 216 references were found. After establishing the inclusion and exclusion criteria based on the analysis of titles and abstracts, 173 articles were excluded from the review. A total of 43 publications were read in full. Finally, 16 articles were included in the review. It was shown that regular physical activity during pregnancy, pregnancy, and puerperium, or in the postnatal period itself as compared to inactivity, reduces the risk of developing depression in pregnant women and after the birth of a child. Conclusions: Physical activity can be an essential factor in the prevention of depressive disorders of women in the postnatal period.

Keywords: physical activity; postpartum depression; pregnancy; puerperium.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A diagram showing the review (2009 PRISMA-flow diagram stages of the literature).

References

    1. Sharifah Suraya S.J. Beliefs and Practices Surrounding Postpartum Period among Malay Women; Proceedings of the Social Sciences Research; Kota Kinabalu, Sabah, Malaysia. 9–10 June 2014; pp. 409–417.
    1. Bjelica A., Cetkovic N., Trninc-Pjevic A., Mladenovic-Segedi L. The phenomenon of pregnancy—A psychological view. Ginekol. Pol. 2018;89:102–106. doi: 10.5603/GP.a2018.0017.
    1. Rowlands I.J., Redshaw M. Mode of birth and women’s psychological and physical wellbeing in the postnatal period. BMC Pregnancy Childbirth. 2012;12 doi: 10.1186/1471-2393-12-138.
    1. Altuntuğ K., Anık Y., Ege E. Traditional practices of mothers in the postpartum period: Evidence from Turkey. Afr. J. Reprod. Health. 2018;22:94–102.
    1. Ospina A.M., Muñoz L., Ruiz C.H. Coping and adaptation during puerperium. Colomb. Méd. 2012;43:168–175.
    1. Leigh B., Milgrom J. Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry. 2008;8:24. doi: 10.1186/1471-244X-8-24.
    1. Blom E.A., Jansen P.W., Verhulst F.C., Hofman A., Raat H., Jaddoe V.W., Coolman M., Steegers E.A., Tiemeier H. Perinatal complications increase the risk of postpartum depression. The Generation R Study. BJOG. 2010;117:1390–1398. doi: 10.1111/j.1471-0528.2010.02660.x.
    1. Hung C.H. The psychosocial consequences for primiparas and multiparas. Kaohsiung J. Med. Sci. 2007;23:352–360. doi: 10.1016/S1607-551X(09)70421-8.
    1. Mehta S., Mehta N. An overview of risk factors associated to post-partum depression in Asia. Ment. Illn. 2014;6:5370. doi: 10.4081/mi.2014.5370.
    1. Takahasi Y., Tamakoshi K. Factors associated with early postpartum maternity blues and depression tendency among Japanese mothers with full-term healthy infants. Nagoya J. Med. Sci. 2014;76:129–138.
    1. Tuteja T.V., Niyogi G.M. Post-Partum psychiatrics disorders. Int. J. Reprod. Contracept. Obs. Gynecol. 2016;5:2497–2502. doi: 10.18203/2320-1770.ijrcog20162621.
    1. Bajurna B., Galęba A., Szwarc A., Petermichl D. Mental changes occurring in women in planned and unplanned pregnancy after delivery. Hyg. Pub. Health. 2014;49:536–542.
    1. Fiala A., Švancara J., Klánová J., Kašpárek T. Sociodemographic and delivery risk factors for developing postpartum depression in a sample of 3233 mothers from the Czech ELSPAC study. BMC Psychiatry. 2017:1–5. doi: 10.1186/s12888-017-1261-y.
    1. Henshaw C. Mood disturbance in the early puerperium: A review. Arch. Womens Ment. Health. 2003;6:33–42. doi: 10.1007/s00737-003-0004-x.
    1. Reck C., Stehle E., Reinig K., Mundt C. Maternity blues as a predictor of DSM-IV depression and anxiety disorders in the first three months postpartum. J. Affect. Disord. 2009;113:77–87. doi: 10.1016/j.jad.2008.05.003.
    1. Schipper-Kochems S., Fehm T., Bizjak G., Fleitmann A.K., Hagenbeck C., Schäfer R., Franz M. Postpartum Depressive Disorder-Psychosomatic Aspects. Geburtshilfe Frauenheilkd. 2019;79:375–381. doi: 10.1055/a-0759-1981.
    1. Edvinsson A., Skalkidou A., Hellgren C., Gingnell M., Ekselius L., Willebrand M., Sundström Poromaa I. Different patterns of attentional bias in antenatal and postpartum depression. Brain Behav. 2017;7:e00844. doi: 10.1002/brb3.844.
    1. Chen L., Wang X., Ding Q., Shan N., Qi H. Development of postpartum depression in pregnant women with preeclampsia: A retrospective study. BioMed Res. Int. 2019:1–7. doi: 10.1155/2019/9601476.
    1. Farhat A., Saeidi R., Mohammadzadeh A., Hesari H. Prevalence of postpartum depression; a longitudinal study. IJN. 2015;6:39–44.
    1. Pope C.J., Mazmanian D. Breastfeeding and postpartum depression: An overview and methodological recommendations for future research. Depress. Res. Treat. 2016:1–9. doi: 10.1155/2016/4765310.
    1. Ankoye R., Acheampong E., Budu-Ainooson A., Obeng E.I., Akwasi A.G. Prevalence of postpartum depression and interventions utilized for its management. Ann. Gen. Psychiatry. 2018 doi: 10.1186/s12991-018-0188-0.
    1. Gomes da Silva Moraes I., Tavares Pinheiro R., Azevedo da Silva R., Lessa Horta B., Rosa Sousa P.L., Duarte Faria A. Prevalence of postpartum depression and associated factors. Rev. Saude Publica. 2006 doi: 10.1590/S0034-89102006000100011.
    1. Patel M., Bailey R.K., Jabeen S., Ali S., Barker N.C., Osiezagha K. Postpartum depression: A review. J. Health Care Poor Underserved. 2012;2:534–542. doi: 10.1353/hpu.2012.0037.
    1. Ghaedrahmati M., Kazemi A., Kheirabadi G., Ebrahimi A., Bahrami M. Postpartum depression risk factors: A narrative review. J. Educ. Health Promot. 2017;6:60. doi: 10.4103/jehp.jehp_9_16.
    1. World Health Organization Maternal Mental Health. [(accessed on 20 May 2019)]; Available online:
    1. Mathisen S.E., Glavin K., Lien L., Lagerlov P. Prevalence and risk factors for postpartum depressive symptoms in Argentina: A cross-sectional study. Int. J. Womens Health. 2013;5:787–793. doi: 10.2147/IJWH.S51436.
    1. Zinga D., Phillips S.D., Born L. Postpartum depression: We know the risks, can it be prevented? Rev. Bras. Psiquiatr. 2005;27:56–64. doi: 10.1590/S1516-44462005000600005.
    1. Janik I., Maciejewska M., Fabian Danielewska A., Korabiusz K., Wawryków A., Stecko M. Emotional disorders in the perinatal period. J. Educ. Health Sport. 2018;8:983–989.
    1. Vigod S., Villegas L., Dennis C.L., Ross L. Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: A systematic review. BJOG. 2010;117:540–550. doi: 10.1111/j.1471-0528.2009.02493.x.
    1. The American College of Obstetricians and Gynecologists Frequently Asked Questions: Labor, Delivery and Postpartum Care. Postpartum Depression. [(accessed on 24 May 2019)]; Available online: .
    1. Rai S., Pathak A., Sharma I. Postpartum psychiatric disorders: Early diagnosis and management. Indian J. Psychiatry. 2015;57 doi: 10.4103/0019-5545.161481.
    1. Rymaszewska J., Dolna M., Gryboś M., Kiejna A. Zaburzenia psychiczne okołoporodowe—Epidemiologia, etiologia, klasyfikacja, leczenie (Mental disorders during pregnancy and postpartum period-epidemiology, etiology, classification and treatment) Ginekol. Pol. 2005;76:322–330.
    1. Sit D.K., Wisner K.L. The identification of postpartum depression. Clin. Obs. Gynecol. 2009;52:456–468. doi: 10.1097/GRF.0b013e3181b5a57c.
    1. Fitelson E., Kim S., Scott Baker A., Leight K. Treatment of postpartum depression: Clinical, psychological and pharmacological options. Int. J. Womens Health. 2011;3:1–14. doi: 10.2147/IJWH.S6938.
    1. Breese McCoy S.J. Postpartum depression: An essential overview for the practitioner. South. Med. J. 2011;104:128–133. doi: 10.1097/SMJ.0b013e318200c221.
    1. Gjerdingen D. The effectiveness of various postpartum depression treatments and the impact of antidepressant drugs on nursing infants. J. Am. Board Fam. Pract. 2003;16:372–382. doi: 10.3122/jabfm.16.5.372.
    1. Chabrol H., Callahan S. Prevention and treatment of postnatal depression. Expert Rev. Neurother. 2007;7:557–576. doi: 10.1586/14737175.7.5.557.
    1. Poudevinge M.S., O’Connor P.J. A review of physical activity patterns in pregnant women and their relationship to psychological health. Sports Med. 2006;36:19–38.
    1. The American College of Obstetricians and Gynecologists Physical Activity and Exercises During Pregnancy and the Postpartum Period. [(accessed on 24 May 2019)]; Available online: .
    1. Blum J.W., Beaudoin C.M., Caton-Lemos L. Physical activity patterns and maternal well-being in postpartum women. Matern. Child Health J. 2004;8:163–169. doi: 10.1023/B:MACI.0000037649.24025.2c.
    1. Carter T., Bastounis A., Guo B., Morrell C.J. The effectiveness of exercise-based interventions for preventing or treating postpartum depression: A systematic review and meta-analysis. Arch. Womens Ment. Health. 2019;22:37–53. doi: 10.1007/s00737-018-0869-3.
    1. Juříková J., Havelka R. Physical Activity in Puerperium Period. [(accessed on 20 May 2019)];EpSBS. doi: 10.15405/epsbs.2019.02.37. Available online:
    1. Walowska J. Usprawnianie kobiet w okresie połogu po porodzie przez cesarskie cięcie (Rehabilitation of women in postnatal period after caesarean section) Rehabil. Prakt. 2018;1:30–34.
    1. Karowicz-Bilińska A., Sikora A., Estemberg D., Brzozowska M., Berner-Trąbska M., Kuś E., Kowalska-Koprek U. Fizjoterapia w położnictwie (Physiotherapy in obstetrics) Ginekol. Pol. 2010;81:441–445.
    1. Artal R., O’Toole M. Guidelines of the Americans College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br. J. Sports Med. 2003;37:6–12. doi: 10.1136/bjsm.37.1.6.
    1. Vargas-Terrones M., Barakat R., Santacruz B., Fernandez-Buhigas I., Mottola M.F. Physical exercise programme during pregnancy decreases perinatal depression risk: A randomised controlled trial. Br. J. Sports Med. 2018;53:348–353. doi: 10.1136/bjsports-2017-098926.
    1. Songøygard K.M., Stafne S.N., Evensen K.A., Salvesen K.A., Vik T., Mørkved S. Does exercise during pregnancy prevent postnatal depression? Acta Obs. Gynecol. Scand. 2012;91:62–67. doi: 10.1111/j.1600-0412.2011.01262.x.
    1. Daley A., Riaz M., Lewis S., Aveyard P., Coleman T., Manyonda I., West R., Lewis B., Marcus B., Taylor A., et al. Physical activity for antenatal and postnatal depression in women attempting to quit smoking: Randomised controlled trial. BMC Pregnancy Childbirth. 2018;18:156. doi: 10.1186/s12884-018-1784-3.
    1. Mohammadi F., Malakooti J., Babapoor J., Mohammad-Alizadeh-Charandabi S. The effect of a home-based exercise intervention on postanatal depression and fatique: A randomized controlled trial. Int. J. Nurs. Pract. 2015;21:478–485. doi: 10.1111/ijn.12259.
    1. Aguilar-Cordero M.J., Sánchez-García J.C., Rodriguez-Blanque R., Sánchez-López A.M., Mur-Villar N. Moderate physical activity in an aquatic environment during pregnancy (SWEP study) and its influence in preventing postpartum depression. J. Am. Psychiatr. Nurses Assoc. 2019;25:112–121. doi: 10.1177/1078390317753675.
    1. LeCheminant J.D., Hinman T., Pratt K.B., Earl N., Bailey B.W., Thackeray R., Tucker L.A. Effect of resistance training on body composition, self-efficiacy, depression, and activity in postpartum women. Scand. J. Med. Sci. Sports. 2014;24:414–421. doi: 10.1111/j.1600-0838.2012.01490.x.
    1. Lewis B.A., Schuver K., Dunsiger S., Samson L., Frayeh A.L., Terrell C., Ciccolo J.T., Avery M.D. Rationale, design, and baseline data for rhe Healthy Mom II Trial: A randomized trial examining the efficacy of exercise and welleness interventions for prevention of postapartum depression. Contemp. Clin. Trials. 2018;70:15–23. doi: 10.1016/j.cct.2018.05.002.
    1. Daley A.J., Winter H., Grimmett C., McGuinness M., McManus R., MacArthur C. Feasibility of an exercise intervention for women with postnatal depression: A pilot randomised controlled trial. Br. J. Gen. Pract. 2008;58:178–183. doi: 10.3399/bjgp08X277195.
    1. Yang C.L., Chen C.H. Effectiveness of aerobic gymnastic exercise on stress, fatique, and sleep quality during postartum: A pilot randomized conrolled trial. Int. J. Nurs. Stud. 2018;77:1–7. doi: 10.1016/j.ijnurstu.2017.09.009.
    1. Heh S.S., Huang L.H., Ho S.M., Fu Y.Y., Wang L.L. Effectiveness of an exercise support program in reducing the severity of postnatal depression in Taiwanese women. Birth. 2008;35:60–65. doi: 10.1111/j.1523-536X.2007.00192.x.
    1. Ko Y.L., Yang C.L., Chiang L.C. Effects of postpartum exercise program on fatigue and depression during „Doing-The-Month” period. J. Nurs. Res. 2008;16:177–186. doi: 10.1097/01.JNR.0000387304.88998.0b.
    1. Da Costa D., Lowensteyn I., Abrahamowicz M., Ionescu-Ittu R., Dritsa M., Rippen N., Cervantes P., Khalifé S. A randmized clinial trail of exercise to alleviate postpartum depressed mood. J. Psychosom. Obs. Gynaecol. 2009;30:191–200. doi: 10.1080/01674820903212136.
    1. Forsyth J., Boath E., Henshaw C., Brown H. Exercise as an adjunct treatment for postpartum depression for women living in an inner city-a pilot study. Health Care Women Int. 2017;38:635–639. doi: 10.1080/07399332.2017.1295049.
    1. Armstrong K., Edwards H. The effectiveness of a pram-walking exercise programme in reducing depressive symptomatology for postnatal women. Int. J. Nurs. Pract. 2004;10:177–194. doi: 10.1111/j.1440-172X.2004.00478.x.
    1. Daley A.J., Blamey R.V., Jolly K., Roalfe A.K., Turner K.M., Coleman S., McGuinsess M., Jones I., Sharp D.J., MacArthur C. A pragmatic randomized controlled trial to evaluate the effectiveness of a facilitated exercise intervention as a treatment for postnatal depression: The PAMPeRS trial. Psychol. Med. 2015;45:2413–2425. doi: 10.1017/S0033291715000409.
    1. Norman E., Sherburn M., Osborne R.H., Galea M.P. An exercise and education program improves well-being of new mothers: A ranomized controlled trial. Phys. Ther. 2010;90:348–355. doi: 10.2522/ptj.20090139.
    1. González G., Moraes M., Sosa C., Umpierrez E., Duarte M., Cal J., Ghione A. Maternal postanatal depression and its impact on child neurodevelopment: A cohort study. Rev. Chil. Pediatr. 2017;88:360–366. doi: 10.4067/S0370-41062017000300008.
    1. Badr L.K., Ayvazin N., Lameh S., Charafeddine L. Is the effect of postaprtum depression on mother-infant bonging universal? Infant Behav. Dev. 2018;51:15–23. doi: 10.1016/j.infbeh.2018.02.003.
    1. Sharma V., Sharma P. Postaprtum Depression: Diagnostic and treatment issues. J. Obs. Gynaecol. Can. 2012;34:436–442. doi: 10.1016/S1701-2163(16)35240-9.
    1. Connolly C.P., Feltz D.L., Pivarnik J.M. Overcoming barriers to physical activity during pregnancy and the postpartum period: The potential impact of social support. Kinesiol. Rev. 2014;3:135–148. doi: 10.1123/kr.2013-0009.
    1. Kołomańska D., Zarawski M., Mazur-Biały A. Physical Activity and Depressive Disorders in Pregnant Women-A Systematic Review. Medicina. 2019;55:212. doi: 10.3390/medicina55050212.
    1. Bahadoran P., Tirkesh F., Oreizi H.R. Association between physical activity 3-12 months after delivery and postpartum well-being. Iran. J. Nurs. Midwifery Res. 2014;19:82–87.
    1. Al-Qahtani A.M., Shaikh M.A.K., Shaikh I.A. Exercise as a treatment modality for depression: A narrative review. Alex. J. Med. 2018;54:429–435. doi: 10.1016/j.ajme.2018.05.004.
    1. Lin T.W., Kuo Y.M. Exercise Benefits Brain Function: The monoamine connection. Brain Sci. 2013;3:39–53. doi: 10.3390/brainsci3010039.
    1. Hung C.L., Tseng J.W., Chao H.H., Hung T.M., Wang H.S. Effect of acute exercise mode on serum Brain-Derived Neurotrophic Factor (BDNF) and task switching performance. J. Clin. Med. 2018;7:301. doi: 10.3390/jcm7100301.
    1. Phillips C. Brain-Derived Neurotrophic Factor, Depression, and Physical Activity: Making the neuroplastic connection. Neural Plast. 2017;2017:7260130. doi: 10.1155/2017/7260130.
    1. Mattson M.P., Maudsley S., Martin B. BDNF and 5-HT: A dynamic duo in age-related neuronal plasticity and neurodegenerative disorders. Trends Neurosci. 2004;27:589–594. doi: 10.1016/j.tins.2004.08.001.
    1. Alghadir A.H., Gabr S.A., Aly F.A. The effects of four weeks aerobic training on saliva cortisol and testosterone in young healthy persons. J. Phys. Ther. Sci. 2015;27:2029–2033. doi: 10.1589/jpts.27.2029.
    1. Frystyk J. Exercise and the Growth Hormone-Insulin-Like Growth Factor Axis. Med. Sci. Sports Exerc. 2010;42:58–66. doi: 10.1249/MSS.0b013e3181b07d2d.
    1. McCurdy A.P., Boulé N.G., Sivak A., Davenport M.H. Effects of exercises on mild-to-moderate depressive symptoms in the postpartum period. Obs. Gynecol. 2017;129:1087–1097. doi: 10.1097/AOG.0000000000002053.
    1. Poyatos-León R., García-Hermoso A., Sanabria-Martínez G., Álvarez-Bueno C., Cavero-Redondo I., Martínez-Vizcaíno V. Effects of exercise-based interventions on postaprtum depression: A meta-analysis of randomized controlled trails. Birth. 2017;44:200–208. doi: 10.1111/birt.12294.
    1. Shakeel N., Richardsen K.R., Martinsen E.W., Eberhard-Gran M., Slinning K., Jenum A.K. Physiacal activity in pregnancy and postpartum depressive symptoms in a multiethnic cohort. J. Affect. Disord. 2018;236:93–100. doi: 10.1016/j.jad.2018.04.081.
    1. Kuhrt K., Hezelgrave N.L., Shennan A.H. Exercise in pregnancy. Obstet. Gynaecol. 2015;17:281. doi: 10.1111/tog.12228.
    1. Okyay E.K., Ucar T. The effect of physical activity level at postpartum period on quality of life and depression level. Med. Sci. 2018;7:587–593. doi: 10.5455/medscience.2018.07.8822.
    1. Szalewska D., Skrzypkowska M. Physical activity patterns, depressive symptoms and awareness of cardiovascular risk factors in postpartum women. Ann. Agric. Environ. Med. 2016;23:502–505. doi: 10.5604/12321966.1219195.
    1. Ali E. Women’s experiences with postpartum anxiety disorders: A narrative literature review. Int. J. Womens Health. 2018;10:237–249. doi: 10.2147/IJWH.S158621.
    1. Groth S.W., David T. New mother’s views of weight and exercise. MCN Am. J. Matern. Child Nurs. 2008;33:364–370. doi: 10.1097/01.NMC.0000341257.26169.30.
    1. Pritchett R.V., Daley A.J., Jolly K. Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis. Br. J. Gen. Pract. 2017;67:e684–e691. doi: 10.3399/bjgp17X692525.
    1. Daley A., Jolly K., MacArthur C. The effectiveness of exercise in the management of post-natal depression: Systematic review and meta-analysis. Fam. Pract. 2009;26:154–162. doi: 10.1093/fampra/cmn101.
    1. Brown A.M., Robinson A., Jones F., Smith A., Williams P., Hanley J. The effectiveness of prescription exercises for women diagnosed with postnatal depression: A systematic review. Midirs Midwifery Dig. 2017;27:488–495.

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