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Leisure-Time Physical Activity in Pregnancy and Maternal-Child Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies

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Abstract

Background

Evidence suggests that leisure-time physical activity (LTPA) during pregnancy is associated with a reduced risk of preeclampsia, gestational diabetes mellitus (GDM), and preterm birth. However, these results are inconsistent when comparing cohort studies and randomized controlled trials (RCTs).

Objective

The purpose of our study was to compare the associations between LTPA in pregnancy and maternal (GDM, preeclampsia, and weight gain during pregnancy) and child health outcomes (preterm birth, birthweight, and fetal growth) between RCTs and cohort studies.

Methods

We performed a systematic search in PubMed, Web of Science, and EBSCO up to 31 August 2015. Inclusion criteria for experimental studies required randomized trials with a control group and exposure to a physical activity structured program. The inclusion criteria for cohort studies required information on LTPA during pregnancy as an exposure and at least one maternal–child health outcome. We assessed the methodological quality of all studies and performed a meta-analysis to produce summary estimates of the effects using random models.

Results

We included 30 RCTs and 51 cohort studies. The meta-analysis of RCTs indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower likelihood of delivering a large-for-gestational-age infant. Cohort studies indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower risk of preterm delivery.

Conclusions

Our findings support the promotion of LTPA in pregnancy as a strategy to improve maternal and child health.

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Acknowledgments

Shana G. da Silva thanks the National Council of Scientific and Technological Development (CNPq) for her scholarship. Luiza I. Ricardo thanks the Coordination for the improvement of Higher Education Personnel (CAPES) for her scholarship.

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Authors and Affiliations

  1. Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3º piso, Bairro Centro, Pelotas, Rio Grande do Sul, CEP: 96020-220, Brazil, Pelotas, 96020-220, Rio Grande do Sul, Brasil

    Shana G. da Silva, Luiza I. Ricardo & Pedro C. Hallal

  2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    Kelly R. Evenson

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  1. Shana G. da Silva
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  2. Luiza I. Ricardo
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Correspondence to Shana G. da Silva.

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Shana G da Silva, Luiza I Ricardo, Kelly R Evenson, and Pedro C Hallal have no conflicts of interest relevant to the content of this review.

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da Silva, S.G., Ricardo, L.I., Evenson, K.R. et al. Leisure-Time Physical Activity in Pregnancy and Maternal-Child Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies. Sports Med 47, 295–317 (2017). https://doi.org/10.1007/s40279-016-0565-2

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