Physical Activity, Sedentary Behavior, and Postnatal Depressive Symptoms: A Review

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Context

Postnatal depression is highly prevalent in mothers. Although physical activity has been found to reduce the risk of depression in the general population, little is known regarding its link with postnatal depression. This review examined original research investigating the relationship between physical activity and sedentary behavior dose (frequency, intensity, and duration) and domain, and postnatal depressive symptoms.

Evidence acquisition

A systematic search for original research investigating the relationship between physical activity and sedentary behavior dose and domain, and postnatal depressive symptoms, was performed using several electronic databases in early 2012. A total of ten observational and seven intervention studies were included.

Evidence synthesis

Most studies (one cross-sectional, two longitudinal, and six intervention studies) found an inverse association between postpartum leisure-time physical activity (LTPA) and postnatal depressive symptoms. One longitudinal study found that occupational physical activity was positively associated with postnatal depressive symptoms. There was inconclusive evidence to suggest an optimal dose of postpartum physical activity for reducing postnatal depressive symptoms. Two longitudinal studies found an inverse association between antenatal LTPA and presence of postnatal depressive symptoms. One of two studies that investigated sedentary behavior found a positive cross-sectional association between sedentary behavior and presence of postnatal depressive symptoms.

Conclusions

Although studies are limited, on balance, LTPA prior to, during, and after pregnancy may be important for reducing the risk of postnatal depression. Further research is required to determine the optimal dose and domain of physical activity for reducing postnatal depressive symptoms as well as to examine the link between sedentary behavior and postnatal depressive symptoms.

Section snippets

Context

Postnatal depression is defined as depression (major or minor) that occurs after giving birth and up to 12 months post-delivery.1 The illness affects up to 19% of mothers post-pregnancy,2 although studies have shown that elevated depressive symptoms are experienced by approximately 50% of postpartum women.3 This debilitating condition has been linked to a lower quality of life for both mother and newborn.4 Mother–infant interactions are compromised among mothers who are experiencing postnatal

Search Strategy

In early 2012, a systematic search was conducted for original research articles published in the past 20 years (1991–2012) using the following electronic databases: MEDLINE (via PubMed); Cinahl; PsycINFO; SPORTDiscus; ScienceDirect; ProQuest; and Google Scholar. Included in the search were the following terms: physical activ*, exercise, sedentary behav*, TV/television viewing, sitting, computer, postnatal, postpartum, depress*, mental health, new mothers, women. Reference lists of relevant

Evidence Synthesis

Approximately 1700 citations were initially identified. After all abstracts were reviewed, a total of 22 studies were found to be potentially eligible for inclusion. After screening the full papers according to the inclusion criteria (as described in the Evidence Acquisition section), five studies were excluded (one43 was a protocol paper, two44, 45 did not measure physical activity/sedentary behavior, and two46, 47 included broad measures of well-being rather than including a measure of

Discussion

The majority of observational (6 of 10) and all intervention studies (n=7) reported an inverse association between physical activity (either pre-pregnancy, during pregnancy, or postpartum) and presence of postnatal depressive symptoms. Far less research has investigated the association between sedentary behavior and postnatal depressive symptoms (n=2), and inconsistent findings were shown. Although associations of physical activity and depression in the general population have been established,

Acknowledgments

No financial disclosures were reported by the authors of this paper.

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