Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis

2018 ◽  
Vol 52 (21) ◽  
pp. 1376-1385 ◽  
Author(s):  
Margie H Davenport ◽  
Ashley P McCurdy ◽  
Michelle F Mottola ◽  
Rachel J Skow ◽  
Victoria L Meah ◽  
...  

ObjectiveTo examine the influence of prenatal exercise on depression and anxiety during pregnancy and the postpartum period.DesignSystematic review with random effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the Population (pregnant women without contraindication to exercise), Intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise), Comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and Outcome (prenatal or postnatal depression or anxiety).ResultsA total of 52 studies (n=131 406) were included. ‘Moderate’ quality evidence from randomised controlled trials (RCTs) revealed that exercise-only interventions, but not exercise+cointerventions, reduced the severity of prenatal depressive symptoms (13 RCTs, n=1076; standardised mean difference: −0.38, 95% CI −0.51 to –0.25, I2=10%) and the odds of prenatal depression by 67% (5 RCTs, n=683; OR: 0.33, 95% CI 0.21 to 0.53, I2=0%) compared with no exercise. Prenatal exercise did not alter the odds of postpartum depression or the severity of depressive symptoms, nor anxiety or anxiety symptoms during or following pregnancy. To achieve at least a moderate effect size in the reduction of the severity of prenatal depressive symptoms, pregnant women needed to accumulate at least 644 MET-min/week of exercise (eg, 150 min of moderate intensity exercise, such as brisk walking, water aerobics, stationary cycling, resistance training).Summary/ConclusionsPrenatal exercise reduced the odds and severity of prenatal depression.

2018 ◽  
Vol 52 (21) ◽  
pp. 1367-1375 ◽  
Author(s):  
Margie H Davenport ◽  
Stephanie-May Ruchat ◽  
Veronica J Poitras ◽  
Alejandra Jaramillo Garcia ◽  
Casey E Gray ◽  
...  

ObjectiveGestational diabetes mellitus (GDM), gestational hypertension (GH) and pre-eclampsia (PE) are associated with short and long-term health issues for mother and child; prevention of these complications is critically important. This study aimed to perform a systematic review and meta-analysis of the relationships between prenatal exercise and GDM, GH and PE.DesignSystematic review with random effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if published in English, Spanish or French, and contained information on the Population (pregnant women without contraindication to exercise), Intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [e.g., dietary; “exercise + co-intervention”]), Comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and Outcomes (GDM, GH, PE).ResultsA total of 106 studies (n=273 182) were included. ‘Moderate’ to ‘high’-quality evidence from randomised controlled trials revealed that exercise-only interventions, but not exercise+cointerventions, reduced odds of GDM (n=6934; OR 0.62, 95% CI 0.52 to 0.75), GH (n=5316; OR 0.61, 95% CI 0.43 to 0.85) and PE (n=3322; OR 0.59, 95% CI 0.37 to 0.9) compared with no exercise. To achieve at least a 25% reduction in the odds of developing GDM, PE and GH, pregnant women need to accumulate at least 600 MET-min/week of moderate-intensity exercise (eg, 140 min of brisk walking, water aerobics, stationary cycling or resistance training).Summary/conclusionsIn conclusion, exercise-only interventions were effective at lowering the odds of developing GDM, GH and PE.


2018 ◽  
Vol 53 (2) ◽  
pp. 108-115 ◽  
Author(s):  
Margie H Davenport ◽  
Amariah J Kathol ◽  
Michelle F Mottola ◽  
Rachel J Skow ◽  
Victoria L Meah ◽  
...  

ObjectiveTo perform a systematic review of the relationship between prenatal exercise and fetal or newborn death.DesignSystematic review with random-effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [eg, dietary; “exercise + co-intervention”]), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcome (miscarriage or perinatal mortality).ResultsForty-six studies (n=2 66 778) were included. There was ‘very low’ quality evidence suggesting no increased odds of miscarriage (23 studies, n=7125 women; OR 0.88, 95% CI 0.63 to 1.21, I2=0%) or perinatal mortality (13 studies, n=6837 women, OR 0.86, 95% CI 0.49 to 1.52, I2=0%) in pregnant women who exercised compared with those who did not. Stratification by subgroups did not affect odds of miscarriage or perinatal mortality. The meta-regressions identified no associations between volume, intensity or frequency of exercise and fetal or newborn death. As the majority of included studies examined the impact of moderate intensity exercise to a maximum duration of 60 min, we cannot comment on the effect of longer periods of exercise.Summary/conclusionsAlthough the evidence in this field is of ‘very low’ quality, it suggests that prenatal exercise is not associated with increased odds of miscarriage or perinatal mortality. In plain terms, this suggests that generally speaking exercise is ‘safe’ with respect to miscarriage and perinatal mortality.


2018 ◽  
Vol 53 (2) ◽  
pp. 116-123 ◽  
Author(s):  
Margie H Davenport ◽  
Courtney Yoo ◽  
Michelle F Mottola ◽  
Veronica J Poitras ◽  
Alejandra Jaramillo Garcia ◽  
...  

ObjectiveTo investigate the relationships between exercise and incidence of congenital anomalies and hyperthermia.DesignSystematic review with random-effects meta-analysis .Data sourcesOnline databases were searched from inception up to 6 January 2017.Study eligibility criteriaStudies of all designs were eligible (except case studies and reviews) if they were published in English, Spanish or French, and contained information on population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [e.g., dietary; “exercise + co-intervention”]), comparator (no exercise or different frequency, intensity, duration, volume or type of exercise) and outcome (maternal temperature and fetal anomalies).ResultsThis systematic review and meta-analysis included ‘very low’ quality evidence from 14 studies (n=78 735) reporting on prenatal exercise and the odds of congenital anomalies, and ‘very low’ to ‘low’ quality evidence from 15 studies (n=447) reporting on maternal temperature response to prenatal exercise. Prenatal exercise did not increase the odds of congenital anomalies (OR 1.23, 95% CI 0.77 to 1.95, I2=0%). A small but significant increase in maternal temperature was observed from pre-exercise to both during and immediately after exercise (during: 0.26°C, 95% CI 0.12 to 0.40, I2=70%; following: 0.24°C, 95% CI 0.17 to 0.31, I2=47%).Summary/ConclusionsThese data suggest that moderate-to-vigorous prenatal exercise does not induce hyperthermia or increase the odds of congenital anomalies. However, exercise responses were investigated in most studies after 12 weeks’ gestation when the risk of de novo congenital anomalies is negligible.


2018 ◽  
Vol 52 (21) ◽  
pp. 1357-1366 ◽  
Author(s):  
Margie H Davenport ◽  
Frances Sobierajski ◽  
Michelle F Mottola ◽  
Rachel J Skow ◽  
Victoria L Meah ◽  
...  

ObjectiveTo perform a systematic review and meta-analysis to explore the relationship between prenatal exercise and glycaemic control.DesignSystematic review with random-effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies and reviews) if they were published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of acute or chronic exercise, alone (‘exercise-only’) or in combination with other intervention components (eg, dietary; ‘exercise+cointervention’) at any stage of pregnancy), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcome (glycaemic control).ResultsA total of 58 studies (n=8699) were included. There was ‘very low’ quality evidence showing that an acute bout of exercise was associated with a decrease in maternal blood glucose from before to during exercise (6 studies, n=123; mean difference (MD) −0.94 mmol/L, 95% CI −1.18 to −0.70, I2=41%) and following exercise (n=333; MD −0.57 mmol/L, 95% CI −0.72 to −0.41, I2=72%). Subgroup analysis showed that there were larger decreases in blood glucose following acute exercise in women with diabetes (n=26; MD −1.42, 95% CI −1.69 to −1.16, I2=8%) compared with those without diabetes (n=285; MD −0.46, 95% CI −0.60 to −0.32, I2=62%). Finally, chronic exercise-only interventions reduced fasting blood glucose compared with no exercise postintervention in women with diabetes (2 studies, n=70; MD −2.76, 95% CI −3.18 to −2.34, I2=52%; ‘low’ quality of evidence), but not in those without diabetes (9 studies, n=2174; MD −0.05, 95% CI −0.16 to 0.05, I2=79%).ConclusionAcute and chronic prenatal exercise reduced maternal circulating blood glucose concentrations, with a larger effect in women with diabetes.


2018 ◽  
Vol 53 (2) ◽  
pp. 90-98 ◽  
Author(s):  
Margie H Davenport ◽  
Andree-Anne Marchand ◽  
Michelle F Mottola ◽  
Veronica J Poitras ◽  
Casey E Gray ◽  
...  

ObjectiveThe purpose of this review was to investigate the relationship between prenatal exercise, and low back (LBP), pelvic girdle (PGP) and lumbopelvic (LBPP) pain.DesignSystematic review with random effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were eligible (except case studies and reviews) if they were published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [eg, dietary; “exercise + co-intervention”]), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcome (prevalence and symptom severity of LBP, PGP and LBPP).ResultsThe analyses included data from 32 studies (n=52 297 pregnant women). ‘Very low’ to ‘moderate’ quality evidence from 13 randomised controlled trials (RCTs) showed prenatal exercise did not reduce the odds of suffering from LBP, PGP and LBPP either in pregnancy or the postpartum period. However, ‘very low’ to ‘moderate’ quality evidence from 15 RCTs identified lower pain severity during pregnancy and the early postpartum period in women who exercised during pregnancy (standardised mean difference −1.03, 95% CI −1.58, –0.48) compared with those who did not exercise. These findings were supported by ‘very low’ quality evidence from other study designs.ConclusionCompared with not exercising, prenatal exercise decreased the severity of LBP, PGP or LBPP during and following pregnancy but did not decrease the odds of any of these conditions at any time point.


2018 ◽  
Vol 53 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Margie H Davenport ◽  
Stephanie-May Ruchat ◽  
Frances Sobierajski ◽  
Veronica J Poitras ◽  
Casey E Gray ◽  
...  

ObjectiveTo perform a systematic review of the relationships between prenatal exercise and maternal harms including labour/delivery outcomes.DesignSystematic review with random effects meta-analysis and meta-regression.DatasourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise, alone [“exercise-only”] or in combination with other intervention components [e.g., dietary; “exercise + co-intervention”]) and outcome (preterm/prelabour rupture of membranes, caesarean section, instrumental delivery, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms (author defined) and diastasis recti).Results113 studies (n=52 858 women) were included. ‘Moderate’ quality evidence from exercise-only randomised controlled trials (RCTs) indicated a 24% reduction in the odds of instrumental delivery in women who exercised compared with women who did not (20 RCTs, n=3819; OR 0.76, 95% CI 0.63 to 0.92, I 2= 0 %). The remaining outcomes were not associated with exercise. Results from meta-regression did not identify a dose–response relationship between frequency, intensity, duration or volume of exercise and labour and delivery outcomes.Summary/conclusionsPrenatal exercise reduced the odds of instrumental delivery in the general obstetrical population. There was no relationship between prenatal exercise and preterm/prelabour rupture of membranes, caesarean section, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms and diastasis recti.


2018 ◽  
Vol 52 (21) ◽  
pp. 1386-1396 ◽  
Author(s):  
Margie H Davenport ◽  
Victoria L Meah ◽  
Stephanie-May Ruchat ◽  
Gregory A Davies ◽  
Rachel J Skow ◽  
...  

ObjectiveWe aimed to identify the relationship between maternal prenatal exercise and birth complications, and neonatal and childhood morphometric, metabolic and developmental outcomes.DesignSystematic review with random-effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were eligible (except case studies and reviews) if published in English, Spanish or French, and contained information on the relevant population (pregnant women without contraindication to exercise), intervention (subjective/objective measures of frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other intervention components (eg, dietary; ‘exercise+cointervention’)), comparator (no exercise or different frequency, intensity, duration, volume, type or trimester of exercise) and outcomes (preterm birth, gestational age at delivery, birth weight, low birth weight (<2500 g), high birth weight (>4000 g), small for gestational age, large for gestational age, intrauterine growth restriction, neonatal hypoglycaemia, metabolic acidosis (cord blood pH, base excess), hyperbilirubinaemia, Apgar scores, neonatal intensive care unit admittance, shoulder dystocia, brachial plexus injury, neonatal body composition (per cent body fat, body weight, body mass index (BMI), ponderal index), childhood obesity (per cent body fat, body weight, BMI) and developmental milestones (including cognitive, psychosocial, motor skills)).ResultsA total of 135 studies (n=166 094) were included. There was ‘high’ quality evidence from exercise-only randomised controlled trials (RCTs) showing a 39% reduction in the odds of having a baby >4000 g (macrosomia: 15 RCTs, n=3670; OR 0.61, 95% CI 0.41 to 0.92) in women who exercised compared with women who did not exercise, without affecting the odds of growth-restricted, preterm or low birth weight babies. Prenatal exercise was not associated with the other neonatal or infant outcomes that were examined.ConclusionsPrenatal exercise is safe and beneficial for the fetus. Maternal exercise was associated with reduced odds of macrosomia (abnormally large babies) and was not associated with neonatal complications or adverse childhood outcomes.


2019 ◽  
Vol 245 ◽  
pp. 918-927 ◽  
Author(s):  
Daichi Suzuki ◽  
Windy M.V. Wariki ◽  
Maiko Suto ◽  
Noyuri Yamaji ◽  
Yo Takemoto ◽  
...  

2020 ◽  
Author(s):  
Madigan Raper ◽  
Samantha McDonald ◽  
Carol Johnston ◽  
Christy Isler ◽  
Edward Newton ◽  
...  

Abstract Background: Non-Hispanic black (NHB) pregnant women disproportionately experience adverse birth outcomes compared to NH white (NHW) pregnant women. The positive effects of prenatal exercise on maternal and neonatal health may mitigate these disparities. This study evaluated the influence of prenatal exercise on racial/ethnic disparities in gestational age (GA), birthweight (BW), and risks of preterm birth (PTB), cesarean section (CS), and low-birthweight (LBW) neonates.Methods: This study performed a secondary data analysis using data from a 24-week, two-arm exercise intervention trial (ENHANCED by Mom). Women with singleton pregnancies (<16 weeks), aged 18-40 years, BMI between 18.5-34.99 kg/m2, and no preexisting health conditions were eligible. The aerobic exercisers (EX) participated in 150 minutes of moderate-intensity weekly exercise while non-exercising controls (CON) attended low-intensity stretching/breathing sessions. Data on GA, PTB (<37 weeks), BW, LBW (< 2.5 kg), and delivery mode were collected. Poisson, median and linear regressions were performed. Results: Participants with complete data (n=125) were eligible for analyses (EX: n=58, CON: n=67). NHB pregnant women delivered lighter neonates (β=-0.43 kg, 95% CI: -0.68, -0.18, p=0.001). After adjusting for prenatal exercise, racial/ethnic disparities in BW were reduced (β=-0.39 kg, 95% CI: -0.65, -0.13, p=0.004). Prenatal exercise reduced borderline significant racial/ethnic disparities in PTB (p=0.053) and GA (p=0.07) with no effects found for CS and LBW. Conclusions: The findings of this study demonstrate that prenatal exercise may attenuate the racial/ethnic disparities observed in neonatal BW, and possibly GA and PTB. Larger, diverse samples and inclusion of maternal biomarkers (e.g., cytokines) are encouraged to further evaluate these relationships.


2021 ◽  
Vol 12 ◽  
Author(s):  
Miguel Sánchez-Polán ◽  
Evelia Franco ◽  
Cristina Silva-José ◽  
Javier Gil-Ares ◽  
Javier Pérez-Tejero ◽  
...  

Background: Prenatal depression is associated with an increased risk of physical, physiological, cardiovascular, and psychological diseases for mothers and future newborns. Prenatal depression and depressive symptoms could have negative effects on the cognitive, emotional, social, and behavioral development of children.Objective: This study aimed to examine the influence of exercise during pregnancy on the prevalence of prenatal depression and depressive symptoms in the scientific literature.Data Sources: A search was carried out examining different online databases up to November 2020.Methods of Study Selection: A systematic review with random effects meta-analysis was performed. Only randomized controlled trials published in English or Spanish with pregnant populations and interventions with exercise programs carried out during pregnancy were included. The scores obtained by the tools that measured the emotional state and depressive symptoms as well as the number and percentage of depressed women of the study groups were analyzed.Tabulation, Integration, and Results: We analyzed 15 studies and found a negative association between moderate exercise during pregnancy and prenatal depression (ES = −0.36, 95% CI = −0.58, −13, I2 = 80.2%, Pheterogeneity = 0.001). In addition, the studies also showed that women who were inactive during pregnancy had a 16% higher probability of suffering prenatal depression [RR = 0.84 (95% IC = 0.74, 0.96) I2 = 61.9%, Pheterogeneity = 0.010].Conclusion: Supervised exercise during pregnancy may be useful for the prevention and reduction of prenatal depression and depressive symptoms.Systematic Review Registration: Registered in PROSPERO (Registration No. CRD42020164819).


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