Structured Exercise as a Potential Treatment Option for Prenatal Depression

Abstract

PURPOSE: Up to 20% of pregnant women experience prenatal depression and up to 19% will continue to have depressive symptoms in the postpartum. Previous research supports exercise during pregnancy as an effective way to prevent prenatal depression, however evidence is lacking regarding exercise as a potential treatment for women who enter pregnancy already at risk for depression. Therefore the purpose was to determine if exercise during pregnancy is an effective option to treat depression during pregnancy. METHODS: This is a secondary analysis of two randomized controlled trials that followed the same exercise protocol and study methodology in Madrid, Spain. Women <16 weeks pregnant were randomized to an exercise group (EG) or standard care control group (CG). The EG participated in group fitness classes three times per week. The classes included moderate intensity aerobics and resistance training in accordance to the American College of Obstetrics and Gynecology guidelines. All participants completed the Centre for Epidemiologic Studies Depression scale (CES-D) at baseline and at the end of the intervention (36-38 weeks gestation). Women who scored ≥16 on the CES-D at baseline (at risk for depression) were included in the current study. A One-Way ANOVA was performed to determine if there was a difference in post CES-D scores between the EG and CG. A Chi-Square Analysis was performed to determine if there was a difference between the two groups for the number of women who had a decrease in their score at the end of the intervention and also scored below 16 post-intervention. RESULTS: Thirty-six women in the EG and 25 women in the CG scored ≥16 on the CES-D at baseline. Post-intervention, the EG had a significantly lower mean CES-D score (14.4±8.6) than the CG (19.4±11.1; p<0.05). Additionally, more women decreased their score in the EG (n=30, 83.3%) than the CG (n=14, 56%; p<0.05) however there was no difference in the number of women who went below the 16 point cut-off between the two groups. CONCLUSION: A structured exercise program offered during pregnancy may reduce depressive symptoms among women who begin pregnancy already at risk for prenatal depression. Therefore exercise may be a viable treatment option for prenatal depression.