The Role of Exercise in Treating Postpartum Depression: A Review of the Literature

Amanda J. Daley, PhD, C. Psychol; Christine MacArthur, PhD; Heather Winter, MD, MROG, FFPH

Disclosures

J Midwifery Womens Health. 2007;52(1):56-62. 

In This Article

Abstract and Introduction

Abstract

There is now evidence to support the antidepressant effects of exercise in general and in clinical populations. This article reviews the evidence regarding the potential role of exercise, particularly pram walking, as an adjunctive treatment for postpartum depression. Database searches revealed two small randomized controlled trials conducted in Australia which support exercise as a useful treatment for women with postpartum depression. In addition, uncontrolled studies and observational evidence suggest that postpartum women, some of whom were depressed, report benefit from participation in exercise programmes. There are plausible mechanisms by which exercise could have such an effect. Limited evidence supports a relationship between participation in exercise and reduction in postpartum depression. Given the reluctance by some women to use antidepressant medication postpartum and the limited availability of psychological therapies, exercise as a therapeutic possibility deserves further exploration. Further research using well-designed randomized controlled trial methodologies are warranted.

Introduction

Postpartum depression is an important public health issue.[1] In a meta-analysis of 59 studies from various countries, the estimated average prevalence of postpartum depression was 13%.[2] A more recent meta-analysis of 30 studies based only on structured clinical interview assessments estimated point prevalence to be between 6.5% and 12.9%, including both major and minor depression at various times during the first postpartum year.[3] The peak incidence of depression is within the first 4 to 6 weeks after birth, with about half of cases developing in the first 3 months.[4,5] The duration of postpartum depression can be short,[5] although evidence suggests that some women continue to experience depression for up to a year or longer.[4,6] This article reviews the available evidence on the plausibility of exercise as an adjunctive treatment for postpartum depression, with an emphasis on evidence from randomized controlled trials (RCTs).

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