R Ward's research while affiliated with University of Birmingham and other places

Background Antenatal depression can have harmful consequences for the mother and fetus. Exercise may be a useful intervention to prevent and treat antenatal depression.Objectives This systematic review aims to establish whether there is sufficient evidence to conclude that exercise is an effective intervention for preventing and treating antenatal depression.Search strategySearches using electronic databases from MEDLINE, Cochrane Library, CINAHL, EMBASE, AMED and PsycINFO were performed.Selection criteriaRandomised controlled trials (RCT) that compared any type of exercise intervention with any comparator in pregnant women were eligible for inclusion.Data collection and analysisMeta-analysis was performed calculating standardised mean differences (SMD).Main resultsSix trials (seven comparisons) were eligible for inclusion. Meta-analysis showed a significant reduction in depression scores (SMD −0.46, 95% CI −0.87 to −0.05, P = 0.03, I2 = 68%) for exercise interventions relative to comparator groups. The test for subgroup differences in women who were non-depressed (one trial) (SMD −0.74, 95%CI −1.22 to −0.27, P = 0.002) and depressed (five trials) (SMD −0.41, 95% CI −0.88 to 0.07, P = 0.09) at baseline was not significant (P = 0.32). The test for subgroup differences between aerobic (one trial) and non-aerobic exercise (five trials) was also nonsignificant (P = 0.32).Authors' conclusionsWe found some evidence that exercise may be effective in treating depression during pregnancy but this conclusion is based on a small number of low-moderate quality trials with significant heterogeneity and wide confidence intervals.