Hicks Lauren E, Graf Michelle D, Yeo SeonAe
School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Arch Womens Ment Health. 2025 Jun;28(3):515-524. doi: 10.1007/s00737-024-01525-2. Epub 2024 Nov 7.
The perinatal period, spanning from pregnancy through the first year after childbirth, is characterized by significant physiological, psychological, and socio-contextual changes. Women face complex stressors including psychosocial pressures, financial constraints, interpersonal dynamics, anticipatory stress related to parenthood, hormonal fluctuations, and societal expectations. These factors collectively influence the perinatal experience, increasing vulnerabilities and stress levels.
A systematic review was conducted in October 2023 using PubMed, SPORTDiscus, PsycInfo, and Scopus databases. Only English-language publications were included. For the meta-analysis, only randomized controlled trials (RCTs) using the Edinburgh Postnatal Depression Scale (EPDS) were considered. Data extraction was performed independently by two reviewers using Covidence, focusing on study characteristics, population demographics, interventions, and outcomes.
The initial search identified 2,373 articles, with 1,196 duplicates removed, leaving 1,177 articles. After screening titles and abstracts, 1,247 were excluded for not meeting the inclusion criteria, resulting in 30 full-text articles reviewed for eligibility by two researchers. Nineteen studies were included in the systematic review, with four in the meta-analysis. Results indicated that higher levels of physical activity during pregnancy were consistently associated with improved postpartum mental health outcomes, including reduced depressive symptoms, lower anxiety, and enhanced overall well-being. Low-intensity exercises, such as yoga, were particularly effective in reducing postpartum depressive symptoms. The impact of moderate-intensity exercise varied, with some studies showing no significant effects. The meta-analysis of four RCTs using the EPDS demonstrated a significant reduction in depression and anxiety symptoms among postpartum women who participated in physical activity interventions, with a substantial overall effect size.
Developing physical activity and exercise regimens encompassing a range of intensities can address the unique physiological and psychological demands of the perinatal period, maximizing the therapeutic benefits of physical activity interventions.
围产期从怀孕持续至产后第一年，其特点是生理、心理和社会环境发生重大变化。女性面临着复杂的压力源，包括心理社会压力、经济限制、人际关系动态、为人父母相关的预期压力、激素波动以及社会期望。这些因素共同影响围产期体验，增加了脆弱性和压力水平。
2023年10月使用PubMed、SPORTDiscus、PsycInfo和Scopus数据库进行了系统综述。仅纳入英文出版物。对于荟萃分析，仅考虑使用爱丁堡产后抑郁量表（EPDS）的随机对照试验（RCT）。两名审阅者使用Covidence独立进行数据提取，重点关注研究特征、人群人口统计学、干预措施和结果。
初步检索识别出2373篇文章，去除1196篇重复文章后，剩余1177篇文章。在筛选标题和摘要后，排除1247篇不符合纳入标准的文章，最终两名研究人员对30篇全文进行了资格审查。19项研究纳入系统综述，4项纳入荟萃分析。结果表明，孕期较高水平的身体活动与产后心理健康状况改善始终相关，包括抑郁症状减轻、焦虑降低和整体幸福感增强。低强度运动，如瑜伽，在减轻产后抑郁症状方面特别有效。中等强度运动的影响各不相同，一些研究显示无显著效果。对4项使用EPDS的RCT进行的荟萃分析表明，参与身体活动干预的产后女性的抑郁和焦虑症状显著减轻，总体效应量较大。
制定涵盖一系列强度的身体活动和锻炼方案可以满足围产期独特的生理和心理需求，最大限度地发挥身体活动干预的治疗益处。
