Effects of Exercise on Mild-to-Moderate Depressive Symptoms in the Postpartum Period

医学 严格标准化平均差 随机对照试验 产后抑郁症 奇纳 萧条(经济学) 置信区间 产后 物理疗法 荟萃分析 抑郁症状 人口 临床试验 梅德林 内科学 精神科 心理干预 怀孕 焦虑 宏观经济学 环境卫生 生物 政治学 法学 经济 遗传学
作者
Ashley McCurdy,Normand G. Boulé,Allison Sivak,Margie H. Davenport
出处
期刊:Obstetrics & Gynecology [Lippincott Williams & Wilkins]
卷期号:129 (6): 1087-1097 被引量:78
标识
DOI:10.1097/aog.0000000000002053
摘要

OBJECTIVE: To examine the influence of exercise on depressive symptoms and the prevalence of depression in the postpartum period. DATA SOURCES: A structured search of MEDLINE, EMBASE, CINAHL, Sport Discus, Ovid's All EBM Reviews, and ClinicalTrials.gov databases was performed with dates from the beginning of the databases until June 16, 2016. The search combined keywords and MeSH-like terms including, but not limited to, “exercise,” “postpartum,” “depression,” and “randomized controlled trial.” METHODS OF STUDY SELECTION: Randomized controlled trials comparing postpartum exercise (structured, planned, repetitive physical activity) with the standard care for which outcomes assessing depressive symptoms or depressive episodes (as defined by trial authors) were assessed. Trials were identified as prevention trials (women from the general postpartum population) or treatment trials (women were classified as having depression by the trial authors). Effect sizes with 95% confidence intervals (CIs) were calculated using Hedges' g method and standardized mean differences in postintervention depression outcomes were pooled using a random-effects model. TABULATION, INTEGRATION, AND RESULTS: Across all 16 trials (1,327 women), the pooled standardized mean difference was −0.34 (95% CI −0.50 to −0.19, I 2 =37%), suggesting a small effect of exercise among all postpartum women on depressive symptoms. Among the 10 treatment trials, a moderate effect size of exercise on depressive symptoms was found (standardized mean difference−0.48, 95% CI −0.73 to −0.22, I 2 =42%). In six prevention trials, a small effect (standardized mean difference−0.22, 95% CI −0.36 to −0.08, I 2 =2%) was found. In women with depression preintervention, exercise increased the odds of resolving depression postintervention by 54% (odds ratio 0.46, Mantel-Haenszel method, 95% CI 0.25–0.84, I 2 =0%). The trials included in this meta-analysis were small and some had methodologic limitations. CONCLUSION: Light-to-moderate intensity aerobic exercise improves mild-to-moderate depressive symptoms and increases the likelihood that mild-to-moderate depression will resolve.
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