Impact of prenatal exercise on neonatal and childhood outcomes: a systematic review and meta-analysis

Abstract

ObjectiveWe aimed to identify the relationship between maternal prenatal exercise and birth complications, and neonatal and childhood morphometric, metabolic and developmental outcomes.DesignSystematic review with random-effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were eligible (except case studies and reviews) if published in English, Spanish or French, and contained information on the relevant population (pregnant women without contraindication to exercise), intervention (subjective/objective measures of frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other intervention components (eg, dietary; ‘exercise+cointervention’)), comparator (no exercise or different frequency, intensity, duration, volume, type or trimester of exercise) and outcomes (preterm birth, gestational age at delivery, birth weight, low birth weight (<2500 g), high birth weight (>4000 g), small for gestational age, large for gestational age, intrauterine growth restriction, neonatal hypoglycaemia, metabolic acidosis (cord blood pH, base excess), hyperbilirubinaemia, Apgar scores, neonatal intensive care unit admittance, shoulder dystocia, brachial plexus injury, neonatal body composition (per cent body fat, body weight, body mass index (BMI), ponderal index), childhood obesity (per cent body fat, body weight, BMI) and developmental milestones (including cognitive, psychosocial, motor skills)).ResultsA total of 135 studies (n=166 094) were included. There was ‘high’ quality evidence from exercise-only randomised controlled trials (RCTs) showing a 39% reduction in the odds of having a baby >4000 g (macrosomia: 15 RCTs, n=3670; OR 0.61, 95% CI 0.41 to 0.92) in women who exercised compared with women who did not exercise, without affecting the odds of growth-restricted, preterm or low birth weight babies. Prenatal exercise was not associated with the other neonatal or infant outcomes that were examined.ConclusionsPrenatal exercise is safe and beneficial for the fetus. Maternal exercise was associated with reduced odds of macrosomia (abnormally large babies) and was not associated with neonatal complications or adverse childhood outcomes.

Impact of Physical Activity During Pregnancy on Obstetric Outcomes in Taif, Saudi Arabia.

“…23 A metaanalysis has reported that maternal exercise during pregnancy was safe and beneficial for fetus. 24 Moreover, maternal exercise was found associated with reduced odds of macrosomia and was not associated with neonatal complications as well as adverse childhood outcomes. 24 Another study highlighted that there were no significant differences in the low birth weight, fetal or neonatal death between physically active and non-active pregnant women.…”

“…24 Moreover, maternal exercise was found associated with reduced odds of macrosomia and was not associated with neonatal complications as well as adverse childhood outcomes. 24 Another study highlighted that there were no significant differences in the low birth weight, fetal or neonatal death between physically active and non-active pregnant women. 25 The reported evidence are similar to as identified in the current study where no significant difference was found in living status, admission to NICU, and vaginal non instrumental delivery between pregnant women who achieved recommended physical activity level and those who did no.…”

The Effect of Yoga Relaxation on Anxiety Levels among Pregnant Women

“…In addition, prenatal exercise is safe and beneficial for the fetus. The maternal exercise was associated with reduced odds of macrosomia (abnormally large babies) and was not associated with neonatal complications or adverse childhood outcomes (Davenport et al, 2018).…”

Pool walking may temporarily improve renal function by suppressing renin-angiotensin-aldosterone system in pregnant women

“…25,26 By contrast, buoyancy in water might release the gravity-induced compression and improve cardiac preload/output. 17 Conventional physical activities such as land walking might have some benefits, 1,6,10 whereas exercise on land may have potential risks to reduce renal perfusion and urinary volume through vasoconstriction. 17…”

“…However, advantages of behavioral interventions are also inconsistent, and currently, maternal physical activities during pregnancy are not a guideline recommendation. 1,6 For example, in recent systematic reviews, prenatal maternal exercise was safe, had benefits for the fetus, and was not associated with neonatal complications and adverse childhood outcomes, 10 whereas behavioral interventions (including the broad range of education, diet, exercise, and self-monitoring of blood glucose) did not prevent hypertensive disorders of pregnancy. 11 To improve guidelines in maternal physical activities during pregnancy, focusing “specific” physical activities in the biological pathogenesis of preeclampsia should be a priority.…”