Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Physical Education and Recreation, the Women and Children's Health Research Institute, and the Alberta Diabetes Institute, University of Alberta, and the University of Alberta Libraries, Edmonton, Alberta, Canada.
Obstet Gynecol. 2017 Jun;129(6):1087-1097. doi: 10.1097/AOG.0000000000002053.
To examine the influence of exercise on depressive symptoms and the prevalence of depression in the postpartum period.
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."
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=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=42%). In six prevention trials, a small effect (standardized mean difference-0.22, 95% CI -0.36 to -0.08, I=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=0%). The trials included in this meta-analysis were small and some had methodologic limitations.
Light-to-moderate intensity aerobic exercise improves mild-to-moderate depressive symptoms and increases the likelihood that mild-to-moderate depression will resolve.
探讨运动对产后抑郁症状和抑郁发生率的影响。
对 MEDLINE、EMBASE、CINAHL、Sport Discus、Ovid 的所有循证医学评论和 ClinicalTrials.gov 数据库进行了结构化检索，检索日期从数据库开始至 2016 年 6 月 16 日。检索结合了关键词和类似于 MeSH 的术语，包括但不限于“运动”、“产后”、“抑郁”和“随机对照试验”。
比较产后运动（结构化、有计划、重复的身体活动）与标准护理的随机对照试验，其中结局评估抑郁症状或抑郁发作（由试验作者定义）。试验被分为预防试验（来自一般产后人群的女性）或治疗试验（试验作者将女性分类为患有抑郁症）。使用 Hedges'g 方法计算具有 95%置信区间（CI）的效应大小，并使用随机效应模型汇总干预后抑郁结局的标准化均数差。
列表、综合和结果：在所有 16 项试验（1327 名女性）中，汇总的标准化均数差为-0.34（95%CI-0.50 至-0.19，I=37%），提示运动对所有产后女性的抑郁症状有较小的影响。在 10 项治疗试验中，发现运动对抑郁症状有中等程度的效果（标准化均数差-0.48，95%CI-0.73 至-0.22，I=42%）。在 6 项预防试验中，发现效果较小（标准化均数差-0.22，95%CI-0.36 至-0.08，I=2%）。在干预前患有抑郁症的女性中，运动使干预后缓解抑郁症的可能性增加了 54%（比值比 0.46，Mantel-Haenszel 法，95%CI 0.25-0.84，I=0%）。纳入本荟萃分析的试验规模较小，部分试验存在方法学局限性。
低到中等强度的有氧运动可改善轻度至中度抑郁症状，并增加轻度至中度抑郁缓解的可能性。
