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Systematic review
Impact of postpartum physical activity on maternal depression and anxiety: a systematic review and meta-analysis
  1. Andy Deprato1,
  2. Stephanie-May Ruchat2,
  3. Muhammad Usman Ali3,
  4. Chenxi Cai1,4,
  5. Milena Forte5,
  6. Madelaine Gierc6,
  7. Sarah Meyer1,
  8. Talia Noel Sjwed1,
  9. Safi Shirazi1,
  10. Brittany A Matenchuk1,
  11. Paris A T Jones1,
  12. Allison Sivak7,
  13. Margie H Davenport1
  1. 1 Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
  2. 2 Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
  3. 3 McMaster Evidence Review and Synthesis Centre and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
  4. 4 State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian, China
  5. 5 Department of Family and Community Medicine, University of Toronto and Granovsky Gluskin Family Medicine Centre, Sinai Health System, Toronto, Ontario, Canada
  6. 6 Population Physical Activity Lab, School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
  7. 7 Geoffrey & Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to Dr Margie H Davenport; mdavenpo{at}ualberta.ca

Abstract

Objective To examine the influence of postpartum exercise on maternal depression and anxiety.

Design Systematic review with random effects meta-analysis and meta-regression.

Data sources Online databases up to 12 January 2024, reference lists, recommended studies and hand searches.

Eligibility criteria Randomised controlled trials (RCTs) and non-randomised interventions of any publication date or language were included if they contained information on the Population (postpartum people), Intervention (subjective or objective measures of frequency, intensity, duration, volume, type, or mode of delivery of exercise), Comparator (no exercise or different exercise measures), and Outcome (postpartum depression, anxiety prevalence, and/or symptom severity).

Results A total of 35 studies (n=4072) were included. Moderate certainty evidence from RCTs showed that exercise-only interventions reduced the severity of postpartum depressive symptoms (19 RCTs, n=1778, SMD: −0.52, 95% CI −0.80 to –0.24, I2=86%, moderate effect size) and anxiety symptoms (2 RCTs, n=513, SMD: −0.25, 95% CI −0.43 to −0.08, I2=0%, small effect size), and the odds of postpartum depression by 45% (4 RCTs, n=303 OR 0.55, 95% CI 0.32 to 0.95, I2=0%) compared with no exercise. No included studies assessed the impact of postpartum exercise on the odds of postpartum anxiety. To achieve at least a moderate reduction in the severity of postpartum depressive symptoms, postpartum individuals needed to accumulate at least 350 MET-min/week of exercise (eg, 80 min of moderate intensity exercise such as brisk walking, water aerobics, stationary cycling or resistance training).

Conclusions Postpartum exercise reduced the severity of depressive and anxiety symptoms and the odds of postpartum depression.

  • Exercise
  • Depression
  • Anxiety

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/bjsports-2024-108478

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • X @milena_forte, @ExercisePreg

    • Correction notice This article has been corrected since it published Online First. The guideline title has been amended to: Canadian Society for Exercise Physiology (CSEP) 2025 Canadian Guideline for Physical Activity, Sedentary Behaviour, and Sleep throughout the First Year Postpartum.

    • Contributors MHD, S-MR, MU, MF, CC contributed to the conception of the study. MHD, S-MR, MU, AS contributed to the design of the study and development of the search strategy. AS conducted the systematic search. AD, CC, SM, TNS, SS, BAM, PATJ completed the acquisition of data. AD performed the data analysis. MHD, S-MR, MU, AD CC, MF, PATJ assisted with the interpretation. AD was the principal writer of the manuscript. All authors contributed to the drafting and revision of the final article. All authors approved the final submitted version of the manuscript. MHD is the guarantor.

    • Funding This study was funded by the Christenson Professorship in Active Healthy Living. MHD is funded by a Christenson Professorship in Active Healthy Living. S-MR is funded by the Université du Québec à Trois-Rivières research chair in physical activity and maternal and neonatal health.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.