- 2026-05-15
- Archives of women's mental health 29(3)
- Lei He
- Shiping Wang
- Yuang Cao
- Bolun Wang
- Hongyang Liu
- Jia Zhang
- Feng Xu
- Junfeng Jiao
Study Design
- Type
- Meta-Analysis
- Population
- 4,577 pregnant participants
- Methods
- Bayesian network meta-analysis of 36 randomized controlled trials
Background
Pregnancy-related mental health disorders are an increasingly important global public health concern. Exercise interventions have gained attention as safe, non-pharmacological strategies for improving maternal psychological and neurophysiological well-being. However, comparative evidence regarding different exercise modalities and intensities remains limited.Objective
This study aimed to systematically evaluate and rank the effects of different prenatal exercise modalities and compare moderate- versus low-intensity exercise protocols on maternal mental health and neurophysiological outcomes during pregnancy.Methods
A Bayesian network meta-analysis was conducted following PRISMA-NMA guidelines. PubMed, Embase, Cochrane Central, and PsycINFO were systematically searched. Thirty-six randomized controlled trials involving 4,577 pregnant participants were included. Methodological quality was assessed using the Cochrane RoB 2.0 tool. Treatment effects were ranked using the surface under the cumulative ranking curve method.Results
Moderate-intensity aerobic training showed the strongest effect on reducing prenatal depression, with a SUCRA value of 0.89. Yoga-based interventions were particularly effective for anxiety reduction, with a SUCRA value of 0.76, and ranked second in the overall outcome evaluation, with a SUCRA value of 0.82. Neurophysiological findings indicated that yoga showed the greatest benefit for cortisol regulation, whereas aquatic exercise demonstrated distinctive anti-inflammatory effects. Subgroup analyses suggested that moderate-intensity exercise tended to produce greater reductions in depression, while low-intensity exercise showed comparable or superior effects on anxiety and cortisol modulation. Meta-regression further indicated that interventions conducted three times per week and lasting more than 12 weeks were associated with larger effect sizes. The certainty of evidence ranged from moderate to high across primary comparisons.Conclusion
This network meta-analysis provides a preliminary evidence hierarchy for prenatal exercise interventions. Moderate-intensity aerobic exercise may be most beneficial for reducing prenatal depression, while yoga appears particularly suitable for anxiety and cortisol regulation. These findings offer clinicians a reference framework for individualized prenatal exercise recommendations and support the integration of exercise into maternal mental healthcare.