Outcome measures and major findings of the included studies
| Reference | Outcomes | Major findings | |||||||||
| Fertility | Fetal birth weight including IUGR | Maternal/fetal circulation (mHR*, fHR**, umbilical/uterine) | APGAR/infant development | Preterm birth | Miscarriage/ intrauterine fetal death | Birth mode | Pelvic floor disorder | Hypertensive pregnancy disease | Diastasis muscle rectus abdominis | ||
| Almquist et al52 | x | x | Natural birth without complications, healthy child, 49 cm and 3238 g. | ||||||||
| Beilock et al54 | x | x | x | x | x | Maternal complications 8 (30.8%) (preterm labour 3, sinus problems 1, heavy bleeding 1, kidney stones 1, hypertension 1, extended labour 1); fetal complications during pregnancy 3 (11.55%; low birth weight 2, unhealthy 1); fetal complications during labour and delivery 6 (23.1%). | |||||
| Bo et al48 | x | x | x | x | No significant difference between prevalence of low back pain with or without sciatica; UI 39% athletes vs 37% control, BMI lower in athletes 6 weeks postpartum; no sign. Difference in preterm birth (39% athletes vs 44% controls) birth weight, instrumental births or caesarean sections; no sign. Difference in length of nursing period. | ||||||
| Bubnjević et al53 | x | x | x | x | x | x | x | Induction of labour because of low amniotic fluid; vaginal delivery 39+4; infant was born with jaundice, APGAR 10/10. | |||
| Bung et al43 | x | x | x | x | x | Weight gain 9 kg during pregnancy; delivery 11 days after expected day, healthy boy, 3200 g, APGAR 9/10, normal umbilical blood gases submaximal exercise: 150–165 W during pregnancy, 120 W puerperium, 165 W 6 wks postpartum; fHR changes after maternal submaximal exercise varied, generally increased by 1 to 15 bpm; uterine activity (contractions) also did not vary during and after strenuous exercise from the situation at rest. After one sprint (mHR 170 bpm) fetal bradycardia (70 bpm) recovered to 120 bpm within 3 min; athlete experienced dizziness and precollapse symptoms, uterine activity normal. | |||||
| Darroch et al56 | x | 21 injuries were reported postpartum (50% of the athletes), 6 bone stress injuries, 11 musculoskeletal injuries (muscle, tendon and/or ligament strain/sprain or rupture), 2 sciaticas, 2 injuries qualified as ‘other’. | |||||||||
| Davies et al44 | x | x | x | x | x | Normal fetal development (anthropometric, cardiovascular and metabolic measurements) obstetric cholestasis → elective caesarean section after a 36-week gestation period. Healthy twins: birth weights 2.2 kg and 2.3 kg; no complications during the clinical procedures; follow-up medical examinations: twins in good health, developing normally 12 months following birth. | |||||
| Drastig et al60 | x | x | x | One questionnaire was excluded from data analysis because of pre-eclampsia; mean duration of pregnancy 39.5±1.7 weeks (two preterm=13%, 36th week); mean weight of newborns was 3543±403 g; mean height 50.9±2.1 cm. All children were healthy after birth and 1 year later. No climbing accidents. | |||||||
| Kardel et al47 | x | fHR | x | x | x | x | No striae in any women (normally 30%); no differences between the MEG and HEG in duration of labour, birth weight, or 1-min and 5-min APGAR scores. HEG: greater maternal weight gain during pregnancy, earlier onset of labour for those women who gave birth to girls but not for those who gave birth to boys. | ||||
| Penttinen et al49 | x | x | x | x | 23 athletes (77%) regular menstrual cycles, 7 (23%) had irregularities, 4 hormonal treatments; 7 (23%) had experienced spontaneous abortion during first trimester in previous pregnancy; no significant differences in labour parameters between athletes and controls; ET had no harmful side effects on the pregnancies or deliveries of the athletes. | ||||||
| Salvesen et al58 | x | x | x | x | x | fHR was within the normal range (110–160 bpm) with mHR <90% of HRmax; fetal bradycardia (was observed in two pregnant women) and high umbilical artery pulsatile index (PI) occurred when mHR >90% of HRmax. When uterine blow flow below initial value+intensity >90% HRmax and mean uterine artery volume blood flow <50% of the initial value. fHR and umbilical artery pulsatility index normalised quickly after stopping the exercise. Four normal deliveries, one caesarean section, one vacuum delivery, two operative deliveries were due to obstructed labours. | |||||
| Solli et al25 | x | x | x | Increased muscle soreness around the hip after running sessions during third trimester; stopped running 6 weeks before giving birth; heavy strength and exercise training throughout whole pregnancy, volume reduction during third trimester; two sacrum fractures 13–18 weeks and 19–24 weeks postpartum. | |||||||
| Sigurdar-dottir et al50 | x | x | x | No significant difference in the incidence of emergency c-section, length of first and second stages of labour; the incidence of third to fourth degree perineal tears was significantly higher (23.7%) among low-impact athletes than among high-impact athletes (5.1%), no significant differences between athletes and controls. | |||||||
| Sundgot-Borgen et al51 | x | x | x | x | x | x | x | No group differences in fertility problems, miscarriage, preterm birth or low birth weight; both groups decreased training volume all trimesters and the first two postpartum periods compared with prepregnancy, more athletes returned to sport/exercise at weeks 0–6 postpartum, no difference in incontinence; no group differences in complications during pregnancy and delivery, athletes reported fewer common complaints. 4 athletes had a stress fracture postpartum; athletes had higher body dissatisfaction and drive for thinness (DT) postpartum, while controls had a reduced DT score. Number of athletes with clinical eating disorder was reduced postpartum, constant in controls. Athletes were not satisfied with advice related to ST and nutrition during pregnancy. | |||
| Szymanski et al59 | x | 5 highly active women with transient fHR decelerations (short duration (mean 2:37 min)) and alterations in umbilical and uterine artery Doppler indices immediately postexercise. | |||||||||
| Szymanski et al57 | x | x | x | x | x | Groups were similar in age, BMI, and gestational age. Maternal resting HR in the Highly Active group (61.6±7.2 bpm) was significantly lower than that in the non-exercise (79.0±11.6 and Regularly Active (71.9±7.4) groups, p<0.001. Treadmill time was longer in the Highly Active (22.3±2.9 min) group compared with the Regularly Active (16.6±3.4) and non-exercise (12.1±3.6) groups, p<0.001, reflecting higher fitness. With moderate exercise, all umbilical artery Doppler indices were similar pre-exercise and postexercise among groups. With vigorous exercise, Doppler indices were similar in Regularly and Highly Active women, with statistically significant decreases postexercise (p<0.05). Postexercise fetal heart tracings met criteria for reactivity within 20 min after all tests. | |||||
BMI, body mass index; bpm, beats per minute; ET, endurance training; fHR, fetal heart rate; HEG, high-exercise group; HRmax, maximal heart rate; IUGR, intrauterine growth restriction; MEG, medium-exercise group; mHR, maternal heart rate; ST, strength training; UI, urinary incontinence.