Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada.
Br J Sports Med. 2018 Nov;52(21):1376-1385. doi: 10.1136/bjsports-2018-099697.
To examine the influence of prenatal exercise on depression and anxiety during pregnancy and the postpartum period.
Systematic review with random effects meta-analysis and meta-regression.
Online databases were searched up to 6 January 2017.
Studies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the Population (pregnant women without contraindication to exercise), Intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise), Comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and Outcome (prenatal or postnatal depression or anxiety).
A total of 52 studies (n=131 406) were included. 'Moderate' quality evidence from randomised controlled trials (RCTs) revealed that exercise-only interventions, but not exercise+cointerventions, reduced the severity of prenatal depressive symptoms (13 RCTs, n=1076; standardised mean difference: -0.38, 95% CI -0.51 to -0.25, I=10%) and the odds of prenatal depression by 67% (5 RCTs, n=683; OR: 0.33, 95% CI 0.21 to 0.53, I=0%) compared with no exercise. Prenatal exercise did not alter the odds of postpartum depression or the severity of depressive symptoms, nor anxiety or anxiety symptoms during or following pregnancy. To achieve at least a moderate effect size in the reduction of the severity of prenatal depressive symptoms, pregnant women needed to accumulate at least 644 MET-min/week of exercise (eg, 150 min of moderate intensity exercise, such as brisk walking, water aerobics, stationary cycling, resistance training).
SUMMARY/CONCLUSIONS: Prenatal exercise reduced the odds and severity of prenatal depression.
研究产前运动对孕期和产后抑郁和焦虑的影响。
系统评价，随机效应荟萃分析和荟萃回归。
在线数据库检索至 2017 年 1 月 6 日。
所有设计的研究均包括在内（除病例研究外），如果研究发表在英文、西班牙文或法文，并包含有关人群（无运动禁忌的孕妇）、干预（主观或客观测量的频率、强度、持续时间、量或运动类型）、比较（无运动或不同频率、强度、持续时间、量和运动类型）和结果（产前或产后抑郁或焦虑）的信息。
共纳入 52 项研究（n=131406）。来自随机对照试验（RCTs）的“中等”质量证据显示，仅运动干预而非运动+联合干预可降低产前抑郁症状的严重程度（13 项 RCT，n=1076；标准化均数差：-0.38，95%CI-0.51 至-0.25，I²=10%）和产前抑郁症的发生率降低 67%（5 项 RCT，n=683；OR：0.33，95%CI 0.21 至 0.53，I²=0%）与无运动相比。产前运动并未改变产后抑郁症的发生率或抑郁症状的严重程度，也未改变孕期或产后的焦虑或焦虑症状。为了达到降低产前抑郁症状严重程度的至少中等效应量，孕妇需要每周积累至少 644 MET-min 的运动（例如，150 分钟的中等强度运动，如快走、水中有氧运动、固定自行车、阻力训练）。
总结/结论：产前运动可降低产前抑郁的发生率和严重程度。
