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Physical activity and prenatal depression: going beyond statistical significance by assessing the impact of reliable and clinical significant change

Published online by Cambridge University Press:  27 February 2020

Marina Vargas-Terrones Open the ORCID record for Marina Vargas-Terrones [Opens in a new window] ,
Taniya S. Nagpal ,
Maria Perales ,
Harry Prapavessis ,
Michelle F. Mottola  and
Ruben Barakat
Marina Vargas-Terrones*
Affiliation:
AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
Taniya S. Nagpal
Affiliation:
R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
Maria Perales
Affiliation:
Camilo José Cela University, Madrid, Spain Research Institute of Hospital 12 de Octubre (i+12), Madrid, Spain
Harry Prapavessis
Affiliation:
Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
Michelle F. Mottola
Affiliation:
R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada
Ruben Barakat
Affiliation:
AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
*
Author for correspondence: Marina Vargas-Terrones, E-mail: m.vargas.terrones@gmail.com
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Abstract

Background

Previous literature supports exercise as a preventative agent for prenatal depression; however, treatment effects for women at risk for prenatal depression remain unexplored. The purpose of the study was to examine whether exercise can lower depressive symptoms among women who began pregnancy at risk for depression using both a statistical significance and reliable and clinically significant change criteria.

Methods

This study is a secondary analysis of two randomized controlled trials that followed the same exercise protocol. Pregnant women were allocated to an exercise intervention group (IG) or control group (CG). All participants completed the Center for Epidemiological Depression (CES-D) scale at gestational week 9–16 and 36–38. Women with a baseline score ⩾16 were included. A clinically reliable cut-off was calculated as a 7-point change in scores from pre- to post-intervention.

Results

Thirty-six women in the IG and 25 women in the CG scored ⩾16 on the CES-D at baseline. At week 36–38 the IG had a statistically significant lower CES-D score (14.4 ± 8.6) than the CG (19.4 ± 11.1; p < 0.05). Twenty-two women in the IG (61%) had a clinically reliable decrease in their post-intervention score compared to eight women in the CG (32%; p < 0.05). Among the women who met the reliable change criteria, 18 (81%) in the IG and 7 (88%) in the CG had a score <16 post-intervention, with no difference between groups (p > 0.05).

Conclusions

A structured exercise program might be a useful treatment option for women at risk for prenatal depression.

Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 4 , March 2021 , pp. 688 - 693
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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References

Andrews-Fike, C. (1999). A review of postpartum depression. Primary Care Companion to the Journal of Clinical Psychiatry, 1, 9–14.CrossRefGoogle ScholarPubMed
Barakat, R., Pelaez, M., Montejo, R., Luaces, M., & Zakynthinaki, M. (2011). Exercise during pregnancy improves maternal health perception: A randomized controlled trial. American Journal of Obstetrics and Gynecology, 204, 402.e1–402.e7.CrossRefGoogle ScholarPubMed
Barakat, R., Pelaez, M., Cordero, Y., Perales, M., Lopez, C., Coteron, J., & Mottola, M. F. (2016). Exercise during pregnancy protects against hypertension and macrosomia: Randomized clinical trial. American Journal of Obstetrics and Gynecology, 214, 649.e1–649.e8.CrossRefGoogle ScholarPubMed
Busch, A. M., Wagener, T. L., Gregor, K. L., Ring, K. T., & Borrelli, B. (2011). Utilizing reliable and clinically significant change criteria to assess for the development of depression during smoking cessation treatment: The importance of tracking idiographic change. Addictive Behaviors, 36, 1228–1232.CrossRefGoogle ScholarPubMed
Daley, A. J., Foster, L., Long, G., Palmer, C., Robinson, O., Walmsley, H., & Ward, R. (2015). The effectiveness of exercise for the prevention and treatment of antenatal depression: Systematic review with meta-analysis. BJOG: An International Journal of Obstetrics and Gynaecology, 122, 57–62.CrossRefGoogle ScholarPubMed
Davalos, D. B., Yadon, C. A., & Tregellas, H. C. (2012). Untreated prenatal maternal depression and the potential risks to offspring: A review. Archives of Women's Mental Health, 15, 1–14.CrossRefGoogle ScholarPubMed
Davenport, M. H., McCurdy, A. P., Mottola, M. F., Skow, R. J., Meah, V. L., Poitras, V. J., … Ruchat, S.-M. (2018). Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: A systematic review and meta-analysis. British Journal of Sports Medicine, 52, 1376–1385.CrossRefGoogle ScholarPubMed
Diego, M. A., Field, T., Hernandez-Reif, M., Schanberg, S., Kuhn, C., & Gonzalez-Quintero, V. H. (2009). Prenatal depression restricts fetal growth. Early Human Development, 85, 65–70.CrossRefGoogle ScholarPubMed
El-Rafie, M. M., Khafagy, G. M., & Gamal, M. G. (2016). Effect of aerobic exercise during pregnancy on antenatal depression. International Journal of Women's Health, 8, 53–57.Google ScholarPubMed
Figueiredo, B., Canario, C., & Field, T. (2014). Breastfeeding is negatively affected by prenatal depression and reduces postpartum depression. Psychological Medicine, 44, 927–936.CrossRefGoogle ScholarPubMed
Gaston, A., & Prapavessis, H. (2013). Tired, moody and pregnant? Exercise may be the answer. Psychology & Health, 28, 1353–1369.CrossRefGoogle Scholar
Gavin, N. I., Gaynes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics & Gynecology, 106, 1071–1083.CrossRefGoogle ScholarPubMed
Goldberg, L., Elliot, D. L., & Kuehl, K. S. (1988). Assessment of exercise intensity formulas by use of ventilatory threshold. Chest, 94, 95–98.CrossRefGoogle ScholarPubMed
Gregory, A. L. Davies, L. A. W., Mottola, M. F., & MacKinnon, C. (2003). Joint SOGC/CSEP clinical practice guideline: Exercise in pregnancy and the postpartum period. Canadian Journal of Applied Physiology, 28, 330–341.Google Scholar
Institute of Medicine & National Research Council Committee to Reexamine IOM Pregnancy Weight Guidelines. (2009). The national academies collection: Reports funded by national institutes of health. In Rasmussen, K. M. & Yaktine, A. L. (Eds.), Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: National Academies Press. Summary, Table S-1. Available from: https://www.ncbi.nlm.nih.gov/books/NBK32799/.Google Scholar
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.CrossRefGoogle ScholarPubMed
Ko, Y. L., Yang, C. L., & Chiang, L. C. (2008). Effects of postpartum exercise program on fatigue and depression during ‘doing-the-month’ period. The Journal of Nursing Research: JNR, 16, 177–186.CrossRefGoogle ScholarPubMed
Latendresse, G., Elmore, C., & Deneris, A. (2017). Selective serotonin reuptake inhibitors as first-line antidepressant therapy for perinatal depression. Journal of Midwifery & Women's Health, 62, 317–328.CrossRefGoogle ScholarPubMed
Liu, C., Cnattingius, S., Bergstrom, M., Ostberg, V., & Hjern, A. (2016). Prenatal parental depression and preterm birth: A national cohort study. BJOG: An International Journal of Obstetrics and Gynaecology, 123, 1973–1982.CrossRefGoogle ScholarPubMed
Mottola, M. F., Davenport, M. H., Ruchat, S.-M., Davies, G. A., Poitras, V. J., Gray, C. E., … Zehr, L. (2018). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine, 52, 1339–1346.CrossRefGoogle ScholarPubMed
O'Neill, M. E., Cooper, K. A., Mills, C. M., Boyce, E. S., & Hunyor, S. N. (1992). Accuracy of Borg's ratings of perceived exertion in the prediction of heart rates during pregnancy. British Journal of Sports Medicine, 26, 121–124.CrossRefGoogle ScholarPubMed
Perales, M., Cordero, Y., Vargas Terrones, M., Lucia, A., & Barakat, R. (2015a). Exercise and depression in overweight and obese pregnant women: A randomised controlled trial. Archivos de Medicina del Deporte, 167, 70–77.Google Scholar
Perales, M., Refoyo, I., Coteron, J., Bacchi, M., & Barakat, R. (2015b). Exercise during pregnancy attenuates prenatal depression: A randomized controlled trial. Evaluation & The Health Professions, 38, 59–72.CrossRefGoogle Scholar
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Robertson, E., Grace, S., Wallington, T., & Stewart, D. E. (2004). Antenatal risk factors for postpartum depression: A synthesis of recent literature. General Hospital Psychiatry, 26, 289–295.CrossRefGoogle ScholarPubMed
Robledo-Colonia, A. F., Sandoval-Restrepo, N., Mosquera-Valderrama, Y. F., Escobar-Hurtado, C., & Ramirez-Velez, R. (2012). Aerobic exercise training during pregnancy reduces depressive symptoms in nulliparous women: A randomised trial. Journal of Physiotherapy, 58, 9–15.CrossRefGoogle ScholarPubMed
Shen, J. J., Lin, F., & Jackson, T. (2010). Risk of prenatal depression: Differences by race. Ethnicity & Disease, 20, 35–39.Google ScholarPubMed
Soler, J., Perez-Sola, V., Puigdemont, D., Perez-Blanco, J., Figueres, M., & Alvarez, E. (1997). [Validation study of the center for epidemiological studies-depression of a Spanish population of patients with affective disorders]. Actas luso-espanolas de neurologia, psiquiatria y ciencias afines, 25, 243–249.Google Scholar
Taniguchi, C., & Sato, C. (2016). Home-based walking during pregnancy affects mood and birth outcomes among sedentary women: A randomized controlled trial. International Journal of Nursing Practice, 22, 420–426.CrossRefGoogle ScholarPubMed
Vargas-Terrones, M., Barakat, R., Santacruz, B., Fernandez-Buhigas, I., & Mottola, M. F. (2018). Physical exercise programme during pregnancy decreases perinatal depression risk: A randomised controlled trial. British Journal of Sports Medicine, 53, 348–353.CrossRefGoogle ScholarPubMed
Woody, C. A., Ferrari, A. J., Siskind, D. J., Whiteford, H. A., & Harris, M. G. (2017). A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders, 219, 86–92.CrossRefGoogle ScholarPubMed