Spotlight on the fetus: how physical activity during pregnancy influences fetal health: a narrative review

Abstract

Before and during pregnancy, women often aim to improve their lifestyle so as to provide a healthier environment for their developing child. It remains unresolved, however, as to whether physical activity (PA) during pregnancy poses a possible risk or whether it might even have beneficial effects on the developing child. There is increasing evidence that PA during pregnancy is indeed beneficial to maternal physiological and psychological health and that it is generally not detrimental to the fetal cardiovascular system and neuronal function in the developing child. This also led to international recommendations for PAs during pregnancy. In the current review, we aimed to comprehensively assess the evidence of beneficial and harmful effects of maternal PA, including high-performance sports, on fetal development. The different mental and body-based relaxation techniques presented here are frequently performed during pregnancy. We found a considerable number of studies addressing these issues. In general, neither low key, moderate maternal PA nor relaxation techniques were observed to have a harmful effect on the developing child. However, we identified some forms of PA which could have at least a transient unfavourable effect. Notably, the literature currently available does not provide enough evidence to enable us to make a general conclusive statement on this subject. This is due to the lack of longitudinal studies on the metabolic and cognitive effects of regular PA during pregnancy and the wide diversity of methods used. In particular, the kind of PA investigated in each study differed from study to study.

Physical activity and sedentary behaviours during pregnancy are associated with neonatal size at birth

“…This study adds to the multitude of data describing the risks of entering pregnancy overweight or obese, [2,[27][28][29][30] and further elucidates these relationships by showing that maternal BMI increases both fetal and neonatal adiposity -both of which have been linked to later life obesity. [2,10,15,31] In this study, 60% of mothers entered pregnancy overweight or obese -which is indicative of a population of young women at risk, who are transferring this risk on to the next generation.…”

“…Furthermore, while maternal physical activity has been examined in relation to delivery outcomes, we have not yet examined how physical activity and sedentary behaviours are related to fetal growth or neonatal FMI or WLR; previous research on this topic shows varied results. [8][9][10][11][12][13][14][15] As maternal physical activity has been associated with GWG, [5] we suspect that physical activity patterns may play a role in the relationship between maternal health during pregnancy and neonatal body composition and size outcomes.…”

Relationships between Objectively Measured Sedentary Behavior during Pregnancy and Infant Birthweight

“…These relationships were independent of physical activity patterns and also key covariates, such as maternal age [ 15 ] and education [ 16 ], that are commonly associated with birthweight. Both physical activity and sedentary behavior during pregnancy might affect not only maternal health outcomes but also fetal development through effects on maternal physiological factors, such as changes to blood flow distribution and uteroplacental blood flow, glucose metabolism and availability for the fetus, and changes to stress hormones in response to activity patterns [ 17 , 18 , 19 ]. Some of these changes, such as higher fasting glucose and risk of insulin resistance observed in some studies of sedentary behavior [ 20 ], might be expected to result in increased risk of macrosomia.…”

Association of Prepregnancy Nutritional Status and Physical Activity Levels with Birth Size Outcomes among West Sumatran Pregnant Women: Results from the Vitamin D Pregnant Mothers Cohort Study in Indonesia

“…The implication of physical activity in early pregnancy had a significant association to improve placental function in healthy pregnancy although it showed different results and remains unclear about its impacts on fetal growth in women with pregnancy complications [18]. The effect of maternal physical activity on fetal growth remains debatable on endothelial dysfunction and abnormal perfusion which is leading to preterm birth [12].…”