Physical exercise for perinatal mental health: An umbrella review highlighting the prevalence of yoga over conventional forms of exercise

Abstract

Objective: Perinatal mental health is a clinical and public health priority, given the high prevalence of anxiety, depression, and stress symptoms during pregnancy and postpartum. This umbrella review is aimed to synthesise the available evidence on the effects of physical exercise on perinatal mental health. Method: The review followed the PRIOR guidelines for umbrella reviews, and the protocol was registered in PROSPERO ID: CRD42024590807. Systematic searches were conducted in PubMed, Scopus, and Web of Science up to August 2025. The studies included were systematic reviews, with or without meta-analyses of randomised controlled trials, evaluating physical activity, exercise, or body-based interventions in pregnant or postpartum women, compared to non-intervention groups. Methodological quality was assessed using the AMSTAR-2 criteria, and study overlap was examined through the MOoR model. Results: Nineteen systematic reviews were included, covering a total of 26,065 participants. Yoga was the most frequently studied modality and consistently showed beneficial effects in reducing anxiety symptoms. Other interventions, such as walking, aerobic exercise, or pelvic floor training, showed mixed or non-significant results. Limitations were identified, including poor application of the FITT framework and lack of standardisation. Conclusion: These findings suggest that mind-body interventions, particularly yoga, show more consistent associations, whereas the results for conventional forms of physical exercise are mixed. Moreover, they highlight the importance of integrating psychological components into care strategies, promoting a more holistic approach to maternal mental well-being, although research of higher methodological quality is needed to clarify the magnitude and robustness of these effects.