Supplementary file 4_Impact of Exercise Dose–Response on Maternal Mental Health and Perinatal Depression Prevention: A Systematic Review and Meta–Analysis.docx

Objective<p>To estimate the effect of exercise on perinatal depressive symptoms, focusing on subclinical depression.</p>Methods<p>Randomized controlled trials (RCTs) reporting Edinburgh Postnatal Depression Scale (EPDS) scores and evaluating perinatal exercise interventions were el...

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Main Author: Paulina Fuenzalida (22659980) (author)
Other Authors: Guillermo Droppelmann (22659983) (author), Sandra Mahecha (22659986) (author), Felipe Feijoo (6405326) (author)
Published: 2025
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Summary:Objective<p>To estimate the effect of exercise on perinatal depressive symptoms, focusing on subclinical depression.</p>Methods<p>Randomized controlled trials (RCTs) reporting Edinburgh Postnatal Depression Scale (EPDS) scores and evaluating perinatal exercise interventions were eligible. A systematic search was conducted in MEDLINE/PubMed, Web of Science, Scopus, and the Cochrane Library for studies published between 2000 and 2024. Study quality, risk of bias, and heterogeneity were assessed before synthesizing the results using a random-effects model.</p>Results<p>Nine RCTs met the inclusion criteria. Exercise significantly reduced depressive symptoms (SMD = −0.47; 95% CI = −0.86 to −0.08; p = 0.02) despite high heterogeneity (I<sup>2</sup> = 88%). Subgroup analyses showed stronger effects during pregnancy (SMD = −0.77; 95% CI = −1.40 to −0.15) than in the postpartum period (SMD = −0.05; 95% CI = −0.31 to 0.22).</p>Conclusion<p>Exercise effectively reduces perinatal depressive symptoms and represents a valuable public health intervention. Longer follow-up periods (≥6 months) are needed to confirm the durability of benefits and to evaluate maternal and child outcomes. Future high-quality RCTs with standardized exercise protocols (≥150 min/week of moderate activity) will be essential to translate this evidence into actionable public health and clinical guidelines.</p>