Comparative impact of exercise-based interventions for postpartum depression: A Bayesian network meta-analysis.
Study Goal
The researchers aimed to determine the effectiveness of exercise-based interventions, including pram walking, for managing postpartum depression (PPD) compared to usual care or other exercises.
Results Summary
Pram walking was significantly associated with a reduction in depressive symptoms during the postpartum period, showing better efficacy than yoga and supervised mixed exercise, though the difference was not statistically significant. Exercise, in general, was effective in treating PPD symptoms.
Population
Women aged 20-35 years with postpartum depression (1260 participants across 12 RCTs).
Effective Dosage
Not specified
Duration
At least 4 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
exercise-based interventions | decrease | depressive symptoms | women with postpartum depression | SMD, -0.81 [95% CI, -1.20 to -0.42] | effectively treats | #1 |
pram walking | decrease | depressive symptoms | women during the postpartum period | SMD, -1.00 [95% CI, -2.60 to -0.10] | significantly associated with a reduction of | #2 |
yoga | decrease | depressive symptoms | women during the postpartum period | SMD, -0.73 [95% CI, -1.84 to -0.43] | associated with a reduction of | #3 |
supervised mixed exercise | decrease | depressive symptoms | women during the postpartum period | SMD, -0.77 [95% CI, -1.67 to -0.01] | associated with a reduction of | #4 |
pram walking | decrease | depressive symptoms | women with postpartum depression | SMD, -0.28 [95% CI, -1.86 to 1.22] | was better than | #5 |
pram walking | decrease | depressive symptoms | women with postpartum depression | SMD, -0.23 [95% CI, -1.59 to 1.12] | was better than | #6 |
all commonly prescribed physical exercises | decrease | symptoms of postpartum depression | women with postpartum depression | - | were effective alternative or complementary treatments | #7 |
pram walking | decrease | symptoms of postpartum depression | women with postpartum depression | - | may perform better in improving | #8 |
OBJECTIVE: The current study aimed to address and rank which exercise-based interventions are preferable to standard care/no therapy or another exercise intervention for postpartum depression (PPD) management and provide estimates for future definitive evidence. METHODS: The authors systematically searched PubMed, Embase, the Web of Science, PsycInfo, and ClinicalTrails.gov for randomized controlled trials (RCTs) on exercise-based interventions for PPD from their inception to May 9, 2023. Included were RCTs of exercise-based interventions for PPD with at least 4 weeks' duration. The pooled effects of intervention comparisons were generated by the Bayesian random-effects model, and the quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development, and Evaluations framework. RESULTS: Twelve RCTs (1260 women; mean age, 20-35 years) comparing exercise-based interventions with usual care/no therapy were included. Exercise effectively treats depressive symptoms (standard mean difference [SMD], -0.81 [95% confidence interval (CI), -1.20 to -0.42], P < 0.001). Pram walking was significantly associated with a reduction of depressive symptoms during the postpartum period (SMD, -1.00 [95% CI, -2.60 to -0.10], P = 0.020), as well as yoga (SMD, -0.73 [95% CI, -1.84 to -0.43], P < 0.001) and supervised mixed exercise (SMD, -0.77 [95% CI, -1.67 to -0.01], P = 0.041) compared with usual care/no therapy. In indirect comparisons, pram walking (surface under the cumulative ranking curve, 58.9%) was better than yoga (SMD, -0.28 [95% CI, -1.86 to 1.22], P = 0.322) and supervised mixed exercise (SMD, -0.23 [95% CI, -1.59 to 1.12], P = 0.358). However, the difference was not statistically significant. The confidence in evidence was very low to moderate. CONCLUSION: In women with PPD, all commonly prescribed physical exercises were effective alternative or complementary treatments. However, pram walking may perform better in improving the symptoms of PPD.