Effects of a third-trimester obstetric exercise program on depressive symptoms and pregnancy-related complaints: a randomized controlled trial

Pregnancy, particularly during the third trimester, is associated with increased physical discomfort and psychological distress, which may adversely affect maternal well-being. This study aimed to evaluate the effects of a structured obstetric exercise program on depressive symptoms and pregnancy-related complaints. This randomized controlled trial was conducted in a public hospital in eastern Türkiye from December 2025 to February 2026. A total of 100 pregnant women in the third trimester were randomly assigned to an exercise group ( n = 50) or a control group ( n = 50). The intervention group received a four-week obstetric exercise program comprising weekly supervised sessions and prescribed home exercises, while the control group received routine antenatal care. Pregnancy-related symptoms and their impact on daily functioning were assessed using the Pregnancy Symptoms Inventory (PSI) total score (primary outcome), and depressive symptoms were evaluated using the Beck Depression Inventory (BDI). Post-intervention outcomes were analyzed using analysis of covariance (ANCOVA) adjusted for baseline values and gravidity. Of the 100 randomized participants, 95 completed the post-intervention assessment. In the complete-case ANCOVA, after adjustment for baseline values and gravidity, significant between-group differences were observed for PSI (adjusted mean difference, -28.48; 95% CI, -40.85 to -16.11; F(1,91) = 20.66; p < 0.001; partial η²=0.185) and BDI (adjusted mean difference, -5.78; 95% CI, -8.65 to -2.91; F(1,91) = 15.81; p < 0.001; partial η²=0.148), with lower post-intervention scores in the exercise group. The ITT analysis using multiple imputation yielded similar estimates for PSI (adjusted mean difference, -27.91; 95% CI, -39.80 to -16.00; p < 0.001) and BDI (adjusted mean difference, -5.63; 95% CI, -8.40 to -2.80; p < 0.001). Participants assigned to the obstetric exercise program had lower pregnancy-related symptom burden and self-reported depressive symptom severity after four weeks than those receiving routine antenatal care. These findings support further evaluation of supervised obstetric exercise as a non-pharmacological approach for reducing pregnancy-related symptoms and depressive symptom severity during the third trimester. ClinicalTrials.gov, NCT07170124, registered 5 September 2025.