The effect of yoga on depression, anxiety, and stress during pregnancy and postpartum: A systematic review and meta-analysis.

Common treatments for depression and anxiety include antidepressant medications and psychotherapy. However, concerns regarding medication side effects during breastfeeding and limitations of psychotherapy highlight the need for alternative approaches. This systematic review and meta-analysis aimed to rigorously evaluate the effects of yoga on anxiety, depression, and stress during pregnancy and the postpartum period by synthesizing evidence from existing studies. To enhance clinical relevance, outcomes were pooled based on validated perinatal mental health scales such as EPDS, STAI-S, CES-D, STAI, PSS, SCL-25, SRQ-20, HADS, HRSA, HARS, HDRS, SAS, SDS, PSRS and BDI-II, enabling clinicians to interpret findings using established screening tools. Interventional studies were identified through systematic searches in multiple databases, and data were analyzed using RevMan version 5.3. The risk of bias was assessed using the ROB1 tool for randomized controlled trials (RCTs) and the ROBINS-I tool for quasi-experimental studies. The quality of the included studies was evaluated using the GRADE approach. A total of 35 studies (23 RCTs and 12 quasi-experimental) were included. Meta-analysis showed that yoga may be associated with reductions in scores of prenatal depressions (SMD = -0.98), anxiety (SMD = -1.15), and stress symptoms (SMD = -0.88), particularly in women without prior depressive or anxiety symptoms (P < 0.00001). No statistically significant effects were found among women with existing symptoms. Yoga may be a feasible, safe, and acceptable intervention for reducing postpartum depression, anxiety, and stress in healthy pregnant women. However, methodological limitations, low to very low certainty of evidence and the small number of RCTs, particularly regarding postpartum outcomes, underscore the need for further research. PROSPERO REGISTRATION CODE: CRD42024618001.