TOPLINE:

Regular structured aerobic exercise during pregnancy was associated with a significantly reduced risk for postpartum depression in women with low-risk singleton pregnancies.

METHODOLOGY:

• Researchers conducted a randomised controlled trial to determine whether regular aerobic exercise during pregnancy would reduce postpartum depression in women with singleton pregnancies.
• They evaluated 398 women aged 20-40 years with low-risk singleton pregnancies (gestational age, < 14 weeks) who were randomly assigned to either the exercise or the no exercise group.
• Participants in the exercise group were offered a structured aerobic exercise programme of 60-minute sessions, 3 days per week, until 35 weeks of gestation. The no exercise group did not receive any structured exercise programme or any guidance on physical activity.
• Self-reported postpartum depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Women with an EPDS score ≥ 9 received a closer follow-up and were referred to a psychiatrist for counselling.
• The primary outcome was an EPDS score ≥ 12 at 3 months after delivery; secondary outcomes included an EPDS score ≥ 9 at 3 months after delivery and maternal and perinatal outcomes.

TAKEAWAY:

• At 3 months after delivery, a significantly smaller proportion of women in the exercise group had an EPDS score ≥ 12 (relative risk [RR], 0.30; 95% CI, 0.16-0.55) and ≥ 9 (RR, 0.56; 95% CI, 0.39-0.80) than those in the no exercise group.
• The mean EPDS score was lower for women in the exercise group than for those in the no exercise group (mean difference, -2.00 points; 95% CI, -2.89 to -1.11).
• Women in the exercise group had a higher gestational age at delivery and lower rates of NICU admissions; other maternal and perinatal outcomes were not significantly different between the two groups.

IN PRACTICE:

"The mechanisms by which antenatal exercise may reduce the risk of postpartum depression are, therefore, likely multifactorial. Exercise promotes neuroplasticity and increases levels of brain-derived neurotrophic factor," the authors wrote.

SOURCE:

This study was led by Gabriele Saccone, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy. It was published online on September 21, 2025, in BJOG: An International Journal of Obstetrics & Gynaecology.

LIMITATIONS:

The trial was open label in nature, which could have influenced medical decision-making and the results of the study. This study was single centre in nature, which limited the external generalisability of the findings. Substantial non-compliance with the exercise intervention may have led to an underestimation of its potential benefits.

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.