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Physical activity and perinatal depression and anxiety: a global umbrella review and meta-meta-analysis

Journal
EClinicalMedicine (Q1)
Published
19 July 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Elizabeth Mohr, Helena Ludwig-Walz, Dawid Pieper, Regina Guthold, Mariebelle Kaus, Alexander Pachanov, et al.
PMID
42666712
DOI
10.1016/j.eclinm.2026.104054

Why clinicians should know about it

  • Picked for Neonatology (top studies of the week, 30 August 2026).
  • Picked for Pharmacology (medical) (top studies of the week, 30 August 2026): Physical activity meta‑umbrella for perinatal depression

Abstract

BACKGROUND: Physical activity is increasingly recognized as a non-pharmacological intervention reducing the risk of perinatal depression and anxiety, but findings from previous meta-analyses are heterogeneous. This umbrella review synthesized evidence on the overall effects of physical activity on perinatal depression and anxiety in women, including by activity intensity and type. METHODS: We searched PubMed, Embase, Web of Science, Cochrane Library, PsycINFO, Epistemonikos, DoPHER, CINAHL, Sports Medicine & Education Index for literature published between Jan 2014 and April 2026. Eligible systematic reviews assessed randomized controlled trials of the effect of physical activity interventions on perinatal depression and/or anxiety outcomes. Pairs of authors conducted data extraction, methodological quality (AMSTAR-2) and certainty of evidence (GRADE) assessments. Overlap between included systematic reviews was assessed using the corrected covered area. Random-effects meta-meta-analyses (a meta-analysis of meta-analyses) yielded standardized mean differences (SMDs) with 95% confidence intervals (95% CIs). PROSPERO registry: CRD42024538941. FINDINGS: A total of 4109 studies were retrieved and 20 systematic reviews with meta-analyses were included. Overlap was 8.49%. Overall physical activity reduces depressive symptoms during the perinatal period with moderate certainty of evidence (SMD: -0.56; 95%-CI: -0.93 to -0.19). Light-intensity physical activity (SMD: -0.52; 95% CI: -0.81 to -0.23) may have effects comparable to those of moderate (SMD: -0.43; 95% CI: -0.64 to -0.22) and mixed-intensity (SMD: -0.52; 95% CI: -0.80 to -0.24) interventions. Yoga (SMD: -0.55; 95%-CI: -0.95 to -0.15) and mixed activity (SMD: -0.54; 95%-CI: -0.70 to -0.38) may be particularly beneficial. PA may also be effective in reducing anxiety (SMD: -0.85, 95%-CI: -1.29 to -0.42), though research is more limited. INTERPRETATION: Light and moderate physical activity are positively associated with a reduction in perinatal depressive and anxiety symptoms in women. Physical activity should be recommended as a non-pharmacological, feasible, and cost-effective approach to address perinatal depression, and potentially anxiety, globally. FUNDING: None.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.