Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece.
Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece.
J Affect Disord. 2022 Feb 1;298(Pt A):26-42. doi: 10.1016/j.jad.2021.10.124. Epub 2021 Oct 30.
Exercise improves perinatal depressive (PD) symptoms, but reports call for more robust evidence. This systematic review and meta-analysis aimed at synthesizing evidence exclusively from randomized controlled trials (RCTs) examining the effects of exercise on PD symptoms in women recruited through perinatal health services.
Nine e-databases and fifteen systematic reviews were searched for relevant RCTs. Exercise-specific tools extracted/coded data. A meta-analysis using a random effects model (Standardized Mean Difference [SMD]) investigated the effects of exercise on PD scores post-intervention.
From 285 records, 14 RCTs (2.025 participants) were considered eligible including two RCTs with clinically diagnosed PD women. Exercise showed a statistically significant, small, overall antidepressant effect (SMD = -0.21, 95% CI = -0.31, -0.11, p = 0.0001) with low/non-significant heterogeneity (Q = 17.82, I = 16%, p = 0.27). Only the fail-safe criterion recorded marginally significant publication bias, but trim-fill analysis added no study. Sensitivity analyses increased the overall effect in RCTs showing lower risk of bias or delivering ≥150 min/week moderate intensity aerobic exercise. Subgroup analyses revealed significant antidepressant effects for exercise across various settings, delivery formats, depressive symptoms severities and outcome measures used. Heterogeneity was low/non-significant in all analyses (I ≤ 50%). Hedges' g corrections did not influence the results.
Study limitations include the small number of available trials and clinically diagnosed PD samples and the variety of exercise modalities.
Exercise improved PD symptoms, especially in RCTs with lower risk of bias or with ≥150 min/day moderate intensity aerobic exercise interventions. Findings are clinically useful but more RCTs for clinically diagnosed PD women are needed for firmer conclusions.
运动可以改善围产期抑郁（PD）症状，但需要更多强有力的证据。本系统评价和荟萃分析旨在仅综合来自通过围产期保健服务招募的女性的随机对照试验（RCT）的证据，这些试验检查了运动对 PD 症状的影响。
检索了 9 个电子数据库和 15 篇系统评价，以寻找相关的 RCT。使用特定于运动的工具提取/编码数据。使用随机效应模型（标准化均数差[SMD]）进行荟萃分析，以调查干预后运动对 PD 评分的影响。
从 285 条记录中，有 14 项 RCT（2025 名参与者）被认为符合条件，其中包括 2 项针对临床诊断为 PD 女性的 RCT。运动显示出统计学上显著的、小的、整体抗抑郁作用（SMD=-0.21，95%CI=-0.31，-0.11，p=0.0001），且异质性低/不显著（Q=17.82，I=16%，p=0.27）。只有失效安全标准记录到边缘显著的发表偏倚，但修剪填充分析并未增加任何研究。敏感性分析增加了在显示低风险偏差或提供每周至少 150 分钟中等强度有氧运动的 RCT 中的总体效果。亚组分析显示，在各种环境、交付格式、抑郁症状严重程度和使用的结果测量中，运动对抑郁症都有显著的抗抑郁作用。所有分析的异质性均较低/不显著（I≤50%）。Hedges'g 校正并不影响结果。
研究的局限性包括可用试验和临床诊断 PD 样本的数量较少，以及运动方式的多样性。
运动改善了 PD 症状，特别是在风险较低或每天进行至少 150 分钟中等强度有氧运动干预的 RCT 中。研究结果具有临床意义，但需要更多针对临床诊断 PD 女性的 RCT 以得出更确定的结论。
