Acceptability, feasibility, and preliminary efficacy of a prenatal walking program for depressed pregnant women

Abstract

Depression is common during pregnancy, yet pregnant women often do not engage in standard mental health treatments, which is concerning due to negative consequences associated with untreated maternal depression. Given that exercise can help to decrease depressive symptoms, and most pregnant women are able to safely engage in mild to moderate physical activity, physical activity interventions may be helpful in improving mood among pregnant women, even those with clinical levels of depression. In an open trial, we piloted a 10-week prenatal walking intervention in 18 depressed pregnant women (mean age=28.7 years). Participants wore a pedometer daily to track activity and attended 6 brief counseling sessions over the 10-week period. Indicators of acceptability and feasibility were assessed, as were changes in depression, physical activity, and other clinical outcomes. Results suggest that the prenatal walking intervention is feasible and acceptable. No adverse events were observed, and most women (83%) completed the intervention, attending on average 5.5 of 6 intervention sessions. Findings also support preliminary efficacy of the intervention: depression scores were reduced by endpoint, and physical activity levels increased based on self-report and objective measurement. Women also reported lower anxiety, and positive changes in affect at endpoint. Participants reported high satisfaction on a questionnaire. Though preliminary, findings suggest that a lifestyle physical activity intervention could be a valuable strategy to improve mood during pregnancy. Further research is needed to evaluate the intervention in a more rigorous randomized trial. If proven efficacious, this simple, low-cost intervention could be implemented in prenatal care settings.

Keywords

• Perinatal mental health
• Antenatal depression
• Physical activity
• Exercise
• Pilot trial
• Acceptability and feasibility