Physical activity for antenatal and postnatal depression in women attempting to quit smoking: randomised controlled trial

Adrian Taylor,Paul Aveyard,Amanda Daley,Robert West,Sarah Lewis,Judith Ibison,Isaac Manyonda,Tim Coleman,Michael Ussher,Muhammad Riaz,Bess Marcus,Andrew Kent,Beth Lewis

doi:10.1186/s12884-018-1784-3

Abstract

BackgroundAntenatal depression is associated with harmful consequences for both the mother and child. One intervention that might be effective is participation in regular physical activity although data on this question in pregnant smokers is currently lacking.MethodsWomen were randomised to six-weekly sessions of smoking cessation behavioural-support, or to the same support plus 14 sessions combining treadmill exercise and physical activity consultations.ResultsAmong 784 participants (mean gestation 16-weeks), EPDS was significantly higher in the physical activity group versus usual care at end-of-pregnancy (mean group difference (95% confidence intervals (CIs)): 0.95 (0.08 to 1.83). There was no significant difference at six-months postpartum.ConclusionA pragmatic intervention to increase physical activity in pregnant smokers did not prevent depression at end-of-pregnancy or at six-months postpartum. More effective physical activity interventions are needed in this population.Trial registrationCurrent Controlled Trials ISRCTN48600346. The trial was prospectively registered on 21/07/2008.

Highlights

Antenatal depression is associated with harmful consequences for both the mother and child
Design and interventions This study reports analysis of depression outcomes from a randomised controlled trial (RCT) evaluating the effect of a physical activity intervention on smoking cessation during pregnancy [21]
We examined whether the effect on depression was greater in women who were inactive at baseline and found no evidence among this subgroup, but there was evidence that depression worsened among women who became active in the intervention group

Summary

Introduction

Antenatal depression is associated with harmful consequences for both the mother and child. One intervention that might be effective is participation in regular physical activity data on this question in pregnant smokers is currently lacking. Ten to 20 % of pregnant women become depressed during or after pregnancy [1, 2]. Antenatal depression is associated with harmful consequences for the mother and child, including premature labour, low birth weight, and a compromised mother-child relationship [3,4,5]. Postnatal depression can adversely affect children’s cognitive and emotional development and social behaviour [6]. Antidepressants are effective for treating depression outside of pregnancy [7], but are seldom prescribed during pregnancy due to concerns about potential adverse effects on the fetus or infant [8]. It is important to find alternative effective interventions.

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Discussion

Conclusion