Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhangen, Denmark.
The Research Unit Women's and Children's Health, the Juliane Marie Center for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 2021 Jan;100(1):129-138. doi: 10.1111/aogs.13982. Epub 2020 Sep 15.
Depression is expected to be the leading cause of disability worldwide by 2030. The prevalence is increasing and is two-fold higher in women than in men, women being at particularly high risk during hormonal transition phases such as pregnancy and the postpartum period. The objective for this trial was to assess the effect of supervised group exercise on psychological well-being and symptoms of depression among pregnant women with or at high risk of depression.
This study was undertaken at the Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark, from August 2016 to September 2018. Pregnant women with a current or previous history of depression and/or anxiety requiring treatment within the last 10 years, or use of antidepressants 3 months before or during pregnancy, were randomly assigned to 12 weeks of supervised group exercise from 17 to 22 weeks of gestation twice weekly, or to a control group. The primary outcome was self-reported psychological well-being at 29-34 weeks of gestation, measured by the five-item World Health Organization Well-being Index (WHO-5). Secondary outcomes included delivery outcomes and psychological well-being (WHO-5) 8 weeks postpartum.
The intention-to-treat analysis showed no significant effect on psychological well-being on the primary outcome. Mean WHO-5 score in the intervention group was 2.0 (95% CI -1.3 to 5.2, P = .2) higher than in the control group. Per protocol analysis of women who attended ≥75% of the exercise sessions showed a statistically significant higher mean WHO-5 score relative to the control group at gestational weeks 29-34. Eight weeks postpartum the intervention group reported higher psychological well-being than the control group, mean difference in WHO-5 score of 5.5 (95% CI 1.0-10.1, P = .04).
Supervised group exercise did not improve psychological well-being for women with or at high risk of depression at 29-34 weeks of gestation. Eight weeks postpartum the intervention group reported significantly higher psychological well-being than the control group. Based on our results, supervised exercise in groups is a safe complementary course of treatment alongside the existing antenatal care.
预计到 2030 年，抑郁症将成为全球导致残疾的首要原因。其发病率正在上升，女性是男性的两倍，尤其是在怀孕和产后等激素过渡阶段，女性面临着极高的风险。本试验的目的是评估监督小组运动对患有或有抑郁高风险的孕妇的心理健康和抑郁症状的影响。
这项研究于 2016 年 8 月至 2018 年 9 月在丹麦哥本哈根大学医院里希医院的妇产科进行。研究对象为目前或以前患有抑郁症和/或焦虑症，需要在过去 10 年内接受治疗的孕妇，或在怀孕前 3 个月或怀孕期间使用抗抑郁药的孕妇。这些孕妇被随机分配到 12 周的监督小组运动中，每周两次，从妊娠 17 周到 22 周开始，或对照组。主要结局是 29-34 孕周时自我报告的心理健康状况，采用 5 项世界卫生组织幸福感指数（WHO-5）进行测量。次要结局包括分娩结局和产后 8 周的心理健康状况（WHO-5）。
意向治疗分析显示，主要结局的心理幸福感没有显著影响。干预组的平均 WHO-5 得分为 2.0（95%CI-1.3 至 5.2，P=0.2）高于对照组。对参加至少 75%运动课程的女性进行方案分析，结果显示，在 29-34 孕周时，与对照组相比，干预组的平均 WHO-5 得分有统计学意义上的显著提高。产后 8 周，干预组报告的心理健康状况优于对照组，WHO-5 评分差异为 5.5（95%CI1.0-10.1，P=0.04）。
监督小组运动并不能改善有或有抑郁高风险的孕妇在 29-34 孕周时的心理健康状况。产后 8 周时，干预组报告的心理健康状况显著优于对照组。基于我们的结果，小组监督运动是现有产前保健的一种安全的补充治疗方法。
