INTRODUCTION: Depression is expected to be the leading cause of disability worldwide by 2030. The prevalence is increasing and is two-fold higher in women than in men, women being particular at high risk during hormonal transition phases such as pregnancy and the postpartum period. The objective for this trial was to assess the effect of supervised group exercise on psychological well-being and symptoms of depression among pregnant women with or at high risk of depression.

MATERIAL AND METHODS: This study was undertaken at Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Denmark, from August 2016-September 2018. Pregnant women with a current or previous history of depression or/and anxiety requiring treatment within the last ten years, or use of antidepressants three months prior to or during pregnancy, were randomly assigned to 12 weeks supervised group exercise from 17-22 weeks of gestation twice weekly, or to a control group. The primary outcome was self-reported psychological well-being at 29-34 weeks of gestation, measured by the five-item World Health Organization Well-being Index (WHO-5). Secondary outcomes included delivery outcomes and psychological well-being (WHO-5) eight weeks postpartum.

RESULTS: The intention-to-treat analysis showed no significant effect on psychological well-being on the primary outcome. Mean WHO-5 score in the intervention group was 2.0 (95% CI: -1.3 to 5.2, P=0.2) higher than in the control group. Per protocol analysis of women who attended ≥75% of the exercise sessions showed a statistically significant higher WHO-5 mean relative to controls at gestational weeks 29-34. Eight weeks postpartum the intervention group reported higher psychological well-being than the control group, mean difference in WHO-5 of 5.5 (95% CI: 1.0 to 10.1, P=0.04).

CONCLUSIONS: Supervised group exercise did not improve psychological well-being for women with or at high risk of depression at 29-34 weeks of gestation. Eight weeks postpartum the intervention group reported significantly higher psychological well-being than the control group. Based on our results, supervised exercise in groups is a safe complementary course of treatment alongside the existing antenatal care.