The effect of exercise during pregnancy on health-related quality of life and depression

Document Type : Research Paper


1 Department of Gynecology and Obstetrics, Faculty of Medicine, Shahed University, Tehran, Iran

2 Master of Midwifery, Department of Obstetrics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

3 Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.


Background and Objective: Exercise has different physical and psychological benefits and can help ameliorate women’s physical and psychological changes during pregnancy. This study aimed to investigate the effects of exercise during pregnancy on women’s weight gain, health-related quality of life (HR-QOL), and depression, and neonates’ birth weight and type of childbirth.
Materials and Methods: One hundred women who referred to Mostafa Khomeini Hospital (Tehran) from December 2016 to November 2017 for prenatal care were included into this study and randomized into two groups: the case group (n=50) with women whom exercised for 60 minutes 3 times a week for 12 weeks and the control group (n=50) with no exercise. At baseline and after 12 weeks, both groups completed SF-36 and Edinburg questionnaires for assessing their HR-QOL and depression, respectively. The type of childbirth, neonate’s birth weight, and women’s weight after childbirth were recorded.
Results: The case group had a significantly lower mean ±SD weight gain after 12 weeks as compared with the control group (4.9±1.50 kg vs 6.50±2.47 kg) (P=0.007), and a lower rate of cesarean section (P=0.001). The mean ±SD of neonates’ birth weight was not different between the two groups (P=0.89). The total scores of SF-36, physical and social dimensions, and general health improved in the case group, while significantly decreased in the control group (P<0.05).
Conclusion: Exercise during pregnancy can reduce cesarean section rate and results in less weight gain after pregnancy. It can also improve patients’ HR-QOL and decrease depression. Therefore, it is suggested to be included in the prenatal care protocol.


  1. Neiger R. Long-term effects of pregnancy complications on maternal health: a review. Journal of Clinical Medicine 2017; 6(8):76.
  2. Ryckman KK, Borowski KS, Parikh NI, Saftlas AF. Pregnancy Complications and the Risk of Metabolic Syndrome for the Offspring. Current Cardiovascular Risk 2013;7(3):217-223.
  3. Johnson J, Clifton RG, Roberts JM, et al. Pregnancy outcomes with weight gain above or below the 2009 Institute of Medicine guidelines. Obstetrics and Gynecology 2013;121(5):969-975.
  4. Goldstein RF, Abell SK, Ranasinha S, et al. Association of Gestational Weight Gain With Maternal and Infant Outcomes: A Systematic Review and Meta-analysis. Journal of the American Medical Association 2017;317(21):2207-2225.
  5. Ludwig DS, Currie J. The association between pregnancy weight gain and birthweight: a within-family comparison. Lancet 2010;376 (9745):984-990.
  6. Marcus SM. Depression during pregnancy: rates, risks and consequences--Motherisk Update 2008. Canadian Journal of Clinical Pharmacology 2009;16(1):e15-e22.
  7. Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Current Opinion in Psychiatry 2012;25(2):141-148.
  8. Davalos DB, Yadon CA, Tregellas HC. Untreated prenatal maternal depression and the potential risks to offspring: a review. Archives of Women's Mental Health 2012;15(1):1-14.
  9. Ramírez-Vélez R. Pregnancy and health-related quality of life: A cross sectional study. Colombia Médica 2011; 42(4):476-481.
  10. Lagadec N, Steinecker M, Kapassi A, et al. Factors influencing the quality of life of pregnant women: a systematic review. BMC Pregnancy Childbirth 2018;18(1):455.
  11. Singh K. A study of physical activity, exercise, and physical fitness: Definitions and bifurcation for physical related research. Academic Sports Scholar 2013; 1(11):1-5.
  12. Ferrari N, Graf C. Recommendations for Physical Activity During and After Pregnancy. Gesundheitswesen. 2017;79(S01).
  13. Liu J, Wilcox S ,Whitaker K , Blake C, Addy C. Preventing excessive weight gain during pregnancy and promoting postpartum weight loss: a pilot lifestyle intervention for overweight and obese African American women. Maternal and Child Health Journal 2015; 19(4), 840-849.
  14. ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period . Obstetrics & Gynecology 2015; 126(6), e135-142.
  15. 15- Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V. Exercise and Mental Health 2017;106:48-56.
  16. Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. International Journal of Psychiatry in Medicine 2011;41(1):15-28.
  17. Gustafsson MK, Stafne SN, Romundstad PR, Mørkved S, Salvesen K, Helvik AS. The effects of an exercise programme during pregnancy on health-related quality of life in pregnant women: a Norwegian randomised controlled trial. International Journal of Obstetrics and Gynaecology 2016;123(7):1152-1160.
  18. Petrov Fieril K, Glantz A, Fagevik Olsen M. The efficacy of moderate-to-vigorous resistance exercise during pregnancy: a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica 2015;94(1):35-42.
  19. Harrison CL, Brown WJ, Hayman M, Moran LJ, Redman LM. The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health. Seminars in Reproductive Medicine 2016;34(2):e28-e37.
  20. Bergink V, Kooistra L, Lambregtse-van den Berg MP, et al. Validation of the Edinburgh Depression Scale during pregnancy. Journal of Psychosomatic Research 2011;70(4):385-389.
  21. Tendais I, Figueiredo B, Mota J, Conde A. Physical activity, health-related quality of life and depression during pregnancy. Cadernos de Saúde Pública 2011;27(2):219-228.
  22. Montazeri A, Goshtasebi A, Vahdaninia M, Gandek B. The Short Form Health Survey (SF-36): translation and validation study of the Iranian version. Quality of Life Research 2005;14(3):875-882.
  23. Montazeri A, Torkan B, Omidvari S. The Edinburgh Postnatal Depression Scale (EPDS): translation and validation study of the Iranian version. BMC Psychiatry 2007;7:11.
  24. Cordero Y, Mottola MF, Vargas J, Blanco M, Barakat R. Exercise Is Associated with a Reduction in Gestational Diabetes Mellitus. Medicine & Science in Sports & Exercise 2015;47(7):1328-1333.
  25. Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Cochrane Database of Systematic Reviews 2015;(6):CD007145.
  26. Bisson M, Alméras N, Dufresne SS, et al. A 12-Week Exercise Program for Pregnant Women with Obesity to Improve Physical Activity Levels: An Open Randomised Preliminary Study. PLoS One 2015;10(9):e0137742.
  27. Harris ST, Liu J, Wilcox S, Moran R, Gallagher A. Exercise during pregnancy and its association with gestational weight gain. Maternal and Child Health Journal 2015;19(3):528-537.
  28. De Oliveria Melo AS, Silva JL, Tavares JS, Barros VO, Leite DF, Amorim MM. Effect of a physical exercise program during pregnancy on uteroplacental and fetal blood flow and fetal growth: a randomized controlled trial. Obstetrics & Gynecology 2012;120(2 Pt 1):302-310.
  29. Haakstad L, Bo K. Exercise during pregnancy–Does it impact offspring birth weight parameters? Journal of Science and Medicine in Sport 2012; 15:S340.
  30. Price BB, Amini SB, Kappeler K. Exercise in pregnancy: effect on fitness and obstetric outcomes-a randomized trial. Medicine & Science in Sports & Exercise 2012;44(12):2263-2269.
  31. Barakat R, Pelaez M, Lopez C, Montejo R, Coteron J. Exercise during pregnancy reduces the rate of cesarean and instrumental deliveries: results of a randomized controlled trial. Journal of Maternal-Fetal and Neonatal Medicine 2012;25(11):2372-2376.
  32. Montoya Arizabaleta AV, Orozco Buitrago L, Aguilar de Plata AC, Mosquera Escudero M, Ramirez-Velez R. Aerobic exercise during pregnancy improves health-related quality of life: a randomised trial. Journal of Physiotherapy 2010;56(4):253-258.
  33. Kolu P, Raitanen J, Luoto R. Physical activity and health-related quality of life during pregnancy: a secondary analysis of a cluster-randomised trial. Maternal and Child Health Journal 2014;18(9):2098-2105.
  34. Campolong K, Jenkins S, Clark MM, et al. The association of exercise during pregnancy with trimester-specific and postpartum quality of life and depressive symptoms in a cohort of healthy pregnant women. Archives of Women's Mental Health 2018;21(2):215-224.
  35. Robledo-Colonia AF, Sandoval-Restrepo N, Mosquera-Valderrama YF, Escobar-Hurtado C, Ramírez-Vélez R. Aerobic exercise training during pregnancy reduces depressive symptoms in nulliparous women: a randomised trial. Journal of Physiotherapy 2012;58(1):9-15.
  36. Gjestland K, Bø K, Owe KM, Eberhard-Gran M. Do pregnant women follow exercise guidelines? Prevalence data among 3482 women, and prediction of low-back pain, pelvic girdle pain and depression. British Journal of Sports Medicine 2013;47 (8):515-520.
  37. Gaston A, Prapavessis H. Tired, moody and pregnant? Exercise may be the answer. Psychology & Health 2013;28 (12):1353-1369.