Review finds physical activity linked with fewer depressive symptoms around pregnancy
A review of 17 randomized trials found possible reductions in depressive symptoms, but anxiety findings were inconclusive and overall evidence certainty was low.
Low evidenceReviewInterpret with caution
Medical disclaimer: This article summarizes research findings and is for informational purposes only. It is not medical advice.
Editorial illustration — not from the study.
Researchers searched 10,938 records and included 17 trials comparing physical activity alone with usual care or no intervention. They analyzed prevention-focused studies separately from trials involving participants who already had symptoms or were receiving an intervention for them.
In prevention-focused trials, physical activity was associated with lower depressive symptom scores during pregnancy and after childbirth. A separate exploratory analysis also found lower postpartum depressive symptom scores in symptomatic or treatment-oriented populations. However, the evidence was rated low or very low certainty, and the review did not find a clear effect on anxiety symptoms during pregnancy.
What the review examined
The researchers conducted a systematic review and meta-analysis of randomized controlled trials involving pregnant or postpartum women. Eligible studies tested standalone physical activity programs of any type, frequency, intensity, or duration against usual care or no intervention without additional active components. Seventeen trials met the criteria. Prevention-oriented trials and symptomatic or treatment-oriented trials were analyzed separately. The review was registered in PROSPERO and reported according to Cochrane and PRISMA methods.
Key conclusions
In prevention-oriented trials, physical activity was associated with lower depressive symptom scores during pregnancy, with a standardized mean difference of -0.52 across seven trials. It was also associated with lower postpartum depressive symptom scores, with a standardized mean difference of -0.33 across seven trials. The review rated these findings as low-certainty evidence for pregnancy and very low-certainty evidence after childbirth.
For anxiety symptoms during pregnancy, the analysis did not show a clear difference compared with no intervention: the standardized mean difference was -0.03 across three trials, with a confidence interval ranging from -0.31 to 0.25. In three symptomatic or treatment-oriented trials, physical activity was associated with lower postpartum depressive symptom scores, but this was based on very low-certainty evidence. Exploratory analyses suggested possible benefits from structured programs and programs held about three times weekly for approximately 60 minutes, but those findings also had low or very low certainty.
Where this may apply
These findings may be relevant to pregnant or postpartum women similar to those included in the underlying trials, particularly those enrolled in prevention-focused or symptomatic populations studied by the researchers. The abstract does not establish whether the results apply equally across different ages, health conditions, pregnancy circumstances, activity types, or levels of depressive or anxiety symptoms. The findings should not be assumed to apply to people outside the studied perinatal populations, and they do not show that physical activity has the same effect for every individual.
What this could mean
Depressive and anxiety symptoms can occur during pregnancy and after childbirth, so research on potentially relevant factors is of interest to human health. This review suggests that standalone physical activity programs may be associated with fewer depressive symptoms in some perinatal populations. It does not establish a clear effect on anxiety, and the low or very low certainty means the estimated effects may change with better evidence.
Limitations & evidence assessment
The review included only 17 trials, and the studies differed in their physical activity programs, participants, outcome measures, and methods. The authors noted substantial clinical and methodological heterogeneity, which limits confidence in the size and generalizability of the findings; variation was especially high for postpartum depressive symptoms. Several analyses were based on only three trials, and the evidence was rated low or very low certainty. The abstract does not provide the total number of participants, detailed participant characteristics, or the length of follow-up, so those aspects are unknown.
Why this evidence level: This was a meta-analysis of randomized trials in pregnant or postpartum women, but the review rated the evidence as low or very low certainty. Differences between studies and limited information about participants and interventions reduce confidence in the size and broader relevance of the findings.
Evidence levels are editorial estimates derived from study metadata — they are not clinical appraisals.
// Source
Archives of Women s Mental Health · 2026 · DOI: 10.1007/s00737-026-01752-9
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