The role of physical activity during pregnancy and its impact on the course of labour and labor outcomes - a review of literature
DOI:
https://doi.org/10.12775/QS.2025.41.59997Keywords
Physical activity, course of labour, neonatal outcomes, gestational diabetes, hypertensive disorders of pregnancy, preterm delivery, instrumental delivery, cesarean sectionAbstract
Introduction: Pregnancy is a transformative stage in a woman’s life, often accompanied by questions and concerns about the safety of both the mother and the developing child. Key aspects of daily life, including physical activity, diet, and work, are frequently scrutinized, with many misconceptions persisting about what constitutes a healthy pregnancy. However, scientific evidence consistently demonstrates that an active and healthy pregnancy benefits both maternal and neonatal outcomes.
Aim of the study: This study aims to synthesize current knowledge on the role of physical activity during pregnancy and its impact on labor outcomes. By reviewing recent research, we seek to provide a comprehensive overview of the benefits of physical activity, address barriers to exercise during pregnancy, and highlight evidence-based recommendations. The goal is to raise awareness among healthcare providers and pregnant women about the importance of incorporating physical activity into prenatal care.
Materials and methods: This study incorporated evidence from peer-reviewed articles, meta-analyses, and randomized controlled trials. Over 55 studies, available on PubMed and Google Scholar were analysed and critically reviewed to create a comprehensive overview of the topic.
Conclusion:
Physical activity during pregnancy is a vital component of prenatal care that promotes maternal and neonatal well-being. Regular exercise reduces the likelihood of pregnancy complications and improves delivery outcomes. Additionally, it offers long-term benefits for neonatal development. While current guidelines provide a general framework for exercise during pregnancy, personalized recommendations tailored to individual needs are essential to maximize safety and efficacy. This research emphasizes the importance of raising awareness among healthcare providers and pregnant women about the critical role of physical activity in improving health outcomes during pregnancy and beyond.
References
Yang X, Li H, Zhao Q, Han R, Xiang Z, Gao L. Clinical Practice
Guidelines That Address Physical Activity and Exercise During
Pregnancy: A Systematic Review. J Midwifery Womens Health. 2022
Jan;67(1):53-68. doi: 10.1111/jmwh.13286. Epub 2021 Nov 28.
Erratum in: J Midwifery Womens Health. 2022 Nov;67(6):800-808.
doi: 10.1111/jmwh.13455. PMID: 34841649.
2. Díaz-Burrueco JR, Cano-Ibáñez N, Martín-Peláez S, Khan KS,
Amezcua-Prieto C. Effects on the maternal-fetal health outcomes of
various physical activity types in healthy pregnant women. A
systematic review and meta-analysis. Eur J Obstet Gynecol Reprod
Biol. 2021 Jul;262:203-215. doi: 10.1016/j.ejogrb.2021.05.030. Epub
2021 May 19. PMID: 34058612.
3. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon
G, Carty C, Chaput JP, Chastin S, Chou R, Dempsey PC, DiPietro L,
Ekelund U, Firth J, Friedenreich CM, Garcia L, Gichu M, Jago R,
Katzmarzyk PT, Lambert E, Leitzmann M, Milton K, Ortega FB,
Ranasinghe C, Stamatakis E, Tiedemann A, Troiano RP, van der
Ploeg HP, Wari V, Willumsen JF. World Health Organization 2020
guidelines on physical activity and sedentary behaviour. Br J Sports
M e d . 2 0 2 0 D e c ; 5 4 ( 2 4 ) : 1 4 5 1 - 1 4 6 2 . d o i : 1 0 . 1 1 3 6 /
bjsports-2020-102955. PMID: 33239350; PMCID: PMC7719906.
4. Physical Activity and Exercise During Pregnancy and the Postpartum
Period: ACOG Committee Opinion, Number 804. Obstet Gynecol.
2020 Apr;135(4):e178-e188. doi: 10.1097/AOG.0000000000003772.
PMID: 32217980.
5. Davenport MH, Ruchat SM, Sobierajski F, Poitras VJ, Gray CE, Yoo
C, Skow RJ, Jaramillo Garcia A, Barrowman N, Meah VL, Nagpal
TS, Riske L, James M, Nuspl M, Weeks A, Marchand AA, Slater LG,
Adamo KB, Davies GA, Barakat R, Mottola MF. Impact of prenatal
exercise on maternal harms, labour and delivery outcomes: a
systematic review and meta-analysis. Br J Sports Med. 2019
Jan;53(2):99-107. doi: 10.1136/bjsports-2018-099821. Epub 2018
Oct 18. PMID: 30337349.
6. Walani SR. Global burden of preterm birth. Int J Gynaecol Obstet.
2020 Jul;150(1):31-33. doi: 10.1002/ijgo.13195. PMID: 32524596.
7. Aune D, Schlesinger S, Henriksen T, Saugstad OD, Tonstad S.
Physical activity and the risk of preterm birth: a systematic review
and meta-analysis of epidemiological studies. BJOG. 2017
Nov;124(12):1816-1826. doi: 10.1111/1471-0528.14672. Epub 2017
May 30. PMID: 28374930.
8. Di Mascio D, Magro-Malosso ER, Saccone G, Marhefka GD,
Berghella V. Exercise during pregnancy in normal-weight women
and risk of preterm birth: a systematic review and meta-analysis of
randomized controlled trials. Am J Obstet Gynecol. 2016
Nov;215(5):561-571. doi: 10.1016/j.ajog.2016.06.014. Epub 2016
Jun 16. PMID: 27319364.
9. Magro-Malosso ER, Saccone G, Di Mascio D, Di Tommaso M,
Berghella V. Exercise during pregnancy and risk of preterm birth in
overweight and obese women: a systematic review and meta-analysis
of randomized controlled trials. Acta Obstet Gynecol Scand. 2017
Mar;96(3):263-273. doi: 10.1111/aogs.13087. PMID: 28029178.
10. Barakat R, Zhang D, Sánchez-Polán M, Silva-José C, Gil-Ares J,
Franco E. Is Exercise during Pregnancy a Risk for Gestational Age
and Preterm Delivery? Systematic Review and Meta-Analysis. J Clin
Med. 2023 Jul 26;12(15):4915. doi: 10.3390/jcm12154915. PMID:
37568315; PMCID: PMC10419377.
11. Sweeting A, Hannah W, Backman H, Catalano P, Feghali M, Herman
WH, Hivert MF, Immanuel J, Meek C, Oppermann ML, Nolan CJ,
Ram U, Schmidt MI, Simmons D, Chivese T, Benhalima K.
Epidemiology and management of gestational diabetes. Lancet. 2024
Jul 13;404(10448):175-192. doi: 10.1016/S0140-6736(24)00825-0.
Epub 2024 Jun 20. PMID: 38909620.
12. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS,
Robinson JS; Australian Carbohydrate Intolerance Study in Pregnant
Women (ACHOIS) Trial Group. Effect of treatment of gestational
diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005 Jun
16;352(24):2477-86. doi: 10.1056/NEJMoa042973. Epub 2005 Jun
12. PMID: 15951574.
13. Poolsup N, Suksomboon N, Amin M. Effect of treatment of
gestational diabetes mellitus: a systematic review and meta-analysis.
PLoS One. 2014 Mar 21;9(3):e92485. doi: 10.1371/
journal.pone.0092485. PMID: 24658089; PMCID: PMC3962411.
14. Xie W, Zhang L, Cheng J, Wang Y, Kang H, Gao Y. Physical activity
during pregnancy and the risk of gestational diabetes mellitus: a
systematic review and dose-response meta-analysis. BMC Public
Health. 2024 Feb 23;24(1):594. doi: 10.1186/s12889-024-18131-7.
PMID: 38395913; PMCID: PMC10893683.
15. Martínez-Vizcaíno V, Sanabria-Martínez G, Fernández-Rodríguez R,
Cavero-Redondo I, Pascual-Morena C, Álvarez-Bueno C, Martínez-
Hortelano JA. Exercise during pregnancy for preventing gestational
diabetes mellitus and hypertensive disorders: An umbrella review of
randomised controlled trials and an updated meta-analysis. BJOG.
2023 Feb;130(3):264-275. doi: 10.1111/1471-0528.17304. Epub
2022 Oct 17. PMID: 36156844; PMCID: PMC10092296.
16. Paulsen CP, Bandak E, Edemann-Callesen H, Juhl CB, Händel MN.
The Effects of Exercise during Pregnancy on Gestational Diabetes
Mellitus, Preeclampsia, and Spontaneous Abortion among Healthy
Women-A Systematic Review and Meta-Analysis. Int J Environ Res
Public Health. 2023 Jun 6;20(12):6069. doi: 10.3390/
ijerph20126069. PMID: 37372656; PMCID: PMC10298745.
17. Du MC, Ouyang YQ, Nie XF, Huang Y, Redding SR. Effects of
physical exercise during pregnancy on maternal and infant outcomes
in overweight and obese pregnant women: A meta-analysis. Birth.
2019 Jun;46(2):211-221. doi: 10.1111/birt.12396. Epub 2018 Sep 21.
PMID: 30240042.
18. Rute-Larrieta C, Mota-Cátedra G, Carmona-Torres JM, Mazoteras-
Pardo V, Barroso-Corroto E, Navarrete-Tejero C, Zografakis-
Sfakianakis M, Patelarou A, Martins MM, Faria ADCA, Laredo-
Aguilera JA. Physical Activity during Pregnancy and Risk of
Gestational Diabetes Mellitus: A Meta-Review. Life (Basel). 2024
Jun 13;14(6):755. doi: 10.3390/life14060755. PMID: 38929738;
PMCID: PMC11204808.
19. Li X, Luo R, Qiao B, Ou H. Exercise Intervention Improves Blood
Glucose Levels and Adverse Pregnancy Outcomes in GDM Patients:
A Meta-Analysis. Comput Math Methods Med. 2022 Sep
22;2022:9287737. doi: 10.1155/2022/9287737. PMID: 36238491;
PMCID: PMC9553359.
20. Keating N, Coveney C, McAuliffe FM, Higgins MF. Aerobic or
Resistance Exercise for Improved Glycaemic Control and Pregnancy
Outcomes in Women with Gestational Diabetes Mellitus: A
Systematic Review. Int J Environ Res Public Health. 2022 Aug
30;19(17):10791. doi: 10.3390/ijerph191710791. PMID: 36078508;
PMCID: PMC9518565.
21. Yin YN, Li XL, Tao TJ, Luo BR, Liao SJ. Physical activity during
pregnancy and the risk of gestational diabetes mellitus: a systematic
review and meta-analysis of randomised controlled trials. Br J Sports
Med. 2014 Feb;48(4):290-5. doi: 10.1136/bjsports-2013-092596.
Epub 2013 Sep 13. PMID: 24037671.
22. Gestational Hypertension and Preeclampsia: ACOG Practice
Bulletin, Number 222. Obstet Gynecol. 2020 Jun;135(6):e237-e260.
doi: 10.1097/AOG.0000000000003891. PMID: 32443079.
23. Davenport MH, Ruchat SM, Poitras VJ, Jaramillo Garcia A, Gray
CE, Barrowman N, Skow RJ, Meah VL, Riske L, Sobierajski F,
James M, Kathol AJ, Nuspl M, Marchand AA, Nagpal TS, Slater LG,
Weeks A, Adamo KB, Davies GA, Barakat R, Mottola MF. Prenatal
exercise for the prevention of gestational diabetes mellitus and
hypertensive disorders of pregnancy: a systematic review and meta-
analysis. Br J Sports Med. 2018 Nov;52(21):1367-1375. doi:
10.1136/bjsports-2018-099355. PMID: 30337463.
24. Aune D, Saugstad OD, Henriksen T, Tonstad S. Physical activity and
the risk of preeclampsia: a systematic review and meta-analysis.
Epidemiology. 2014 May;25(3):331-43. doi: 10.1097/
EDE.0000000000000036. PMID: 24713878.
25. Barakat R, Silva-Jose C, Zhang D, Sánchez-Polán M, Refoyo I,
Montejo R. Influence of Physical Activity during Pregnancy on
Maternal Hypertensive Disorders: A Systematic Review and Meta-
Analysis of Randomized Controlled Trials. J Pers Med. 2023 Dec
21;14(1):10. doi: 10.3390/jpm14010010. PMID: 38276226; PMCID:
PMC10817323.
26. Magro-Malosso ER, Saccone G, Di Tommaso M, Roman A,
Berghella V. Exercise during pregnancy and risk of gestational
hypertensive disorders: a systematic review and meta-analysis. Acta
Obstet Gynecol Scand. 2017 Aug;96(8):921-931. doi: 10.1111/
aogs.13151. Epub 2017 May 19. PMID: 28401531.
27. Uccella S, Manzoni P, Marconi N, Toscani C, Biasoli S, Cianci S,
Franchi M, Sorice P, Bertoli F, Zorzato PC, Gallina D, Ghezzi F,
Serati M. Impact of Sport Activity and Physical Exercise on
Obstetrical and Perineal Outcomes at Delivery: A Prospective Study.
Am J Perinatol. 2019 Jul;36(S 02):S83-S90. doi: 10.1055/
s-0039-1691816. Epub 2019 Jun 25. PMID: 31238366.
28. Zhang D, Bo K, Montejo R, Sánchez-Polán M, Silva-José C, Palacio
M, Barakat R. Influence of pelvic floor muscle training alone or as
part of a general physical activity program during pregnancy on
urinary incontinence, episiotomy and third- or fourth-degree perineal
tear: Systematic review and meta-analysis of randomized clinical
trials. Acta Obstet Gynecol Scand. 2024 Jun;103(6):1015-1027. doi:
10.1111/aogs.14744. Epub 2023 Dec 23. PMID: 38140841; PMCID:
PMC11103147.
29. Poyatos-León R, García-Hermoso A, Sanabria-Martínez G, Álvarez-
Bueno C, Sánchez-López M, Martínez-Vizcaíno V. Effects of
exercise during pregnancy on mode of delivery: a meta-analysis.
Acta Obstet Gynecol Scand. 2015 Oct;94(10):1039-47. doi: 10.1111/
aogs.12675. Epub 2015 May 30. PMID: 25965378.
30. Takami M, Tsuchida A, Takamori A, Aoki S, Ito M, Kigawa M,
Kawakami C, Hirahara F, Hamazaki K, Inadera H, Ito S; Japan
Environment & Children’s Study (JECS) Group. Effects of physical
activity during pregnancy on preterm delivery and mode of delivery:
The Japan Environment and Children's Study, birth cohort study.
PLoS One. 2018 Oct 29;13(10):e0206160. doi: 10.1371/
journal.pone.0206160. PMID: 30372455; PMCID: PMC6205641.
31. Chen H, Zhang CJP, Ming WK, Wang Z. The association between
objectively-measured physical activity during pregnancy and the risk
of cesarean delivery: a prospective study. Ginekol Pol.
2022;93(11):916-921. doi: 10.5603/GP.a2022.0094. PMID:
36621971.
32. Chen, B. D., Boyarsky, R., Rozenberg, D., Zipori, Y., Justman, N.,
Bachar, G., Khatib, N., Ginsberg, Y., Weiner, Z., & Beloosesky, R.
(2024). 944 Physical activity during pregnancy. A step-by-step
towards reduced rate of C-sections. American Journal of Obstetrics
and Gynecology. https://doi.org/10.1016/j.ajog.2023.11.972
33. Weng YM, Green J, Yu JJ, Zhang HY, Cui H. The relationship
between incidence of cesarean section and physical activity during
pregnancy among pregnant women of diverse age groups: Dose-
response meta-analysis. Int J Gynaecol Obstet. 2024
Feb;164(2):504-515. doi: 10.1002/ijgo.14915. Epub 2023 Jun 16.
PMID: 37326328.
34. Wang Y, Wu L, Wu X, Zhou C. The Association between Physical
Exercise during Pregnancy and Maternal and Neonatal Health
Outcomes: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials. Comput Math Methods Med. 2022 Aug
21;2022:3462392. doi: 10.1155/2022/3462392. PMID: 36045949;
PMCID: PMC9420626.
35. Ren S, Zhao Q, Luo L, You X, Jin A. Association of physical activity
during pregnancy with labor and delivery in nulliparous patients. Eur
J Obstet Gynecol Reprod Biol X. 2024 Dec 24;25:100361. doi:
10.1016/j.eurox.2024.100361. PMID: 39834627; PMCID:
PMC11743882.
36. Watkins VY, O'Donnell CM, Perez M, Zhao P, England S, Carter EB,
Kelly JC, Frolova A, Raghuraman N. The impact of physical activity
during pregnancy on labor and delivery. Am J Obstet Gynecol. 2021
Oct;225(4):437.e1-437.e8. doi: 10.1016/j.ajog.2021.05.036. Epub
2021 Jun 1. PMID: 34081895; PMCID: PMC10564562.
37. Kondo, Y., Sawa, R., Ebina, A., Takada, M., Fujii, H., Okuyama, Y.,
… Ono, R. (2017). Influence of Habitual Physical Activity During
Late Pregnancy on the Duration of Labor. Journal of Physical
Activity and Health, 14(3), 203–207. doi:10.1123/jpah.2016-0163
38. Ferreira CLM, Guerra CML, Silva AITJ, do Rosário HRV, Pereira
MBFLO. Exercise in Pregnancy: The Impact of an Intervention
Program in the Duration of Labor and Mode of Delivery. Rev Bras
Ginecol Obstet. 2019 Feb;41(2):68-75. doi: 10.1055/
s-0038-1675613. Epub 2018 Nov 14. PMID: 30428489; PMCID:
PMC10416164.
39. WOJTYLA, Anna and MĄCZKA, Martyna. The influence of
pregnant women’s physical activity on selected perinatal parameters.
Journal of Education, Health and Sport. Online. 21 September 2023.
Vol. 14, no. 1, pp. 152-176.
40. Cristina I. Pravia, MD and Merline Benny, MD Cleveland Clinic
Journal of Medicine December 2020, 87 (12) 759-767; DOI: https://
doi.org/10.3949/ccjm.87a.19108
41. Fu M, Song W, Yu G, Yu Y, Yang Q. Risk factors for length of NICU
stay of newborns: A systematic review. Front Pediatr. 2023 Mar
13;11:1121406. doi: 10.3389/fped.2023.1121406. PMID: 36994438;
PMCID: PMC10040659.
42. Grunberg, V.A., Geller, P.A., Bonacquisti, A. et al. NICU infant
health severity and family outcomes: a systematic review of
assessments and findings in psychosocial research. J Perinatol 39,
156–172 (2019). https://doi.org/10.1038/s41372-018-0282-9
43. Silva-Jose, C.; May, L.; Sánchez-Polán, M.; Zhang, D.; Barrera-
Garcimartín, A.; Refoyo, I.; Barakat, R. Influence of Physical
Activity during Pregnancy on Neonatal Complications: Systematic
Review and Meta-Analysis. J. Pers. Med. 2024, 14, 6. https://doi.org/
10.3390/jpm14010006
44. Na, X., Raja, R., Phelan, N. E., Tadros, M. R., Moore, A., Wu, Z.,
Wang, L., Li, G., Glasier, C. M., Ramakrishnaiah, R. R., Andres, A.,
& Ou, X. (2022). Mother’s physical activity during pregnancy and
newborn’s brain cortical development. Frontiers in Human
Neuroscience, 16. https://doi.org/10.3389/fnhum.2022.943341
45. Leão OAA, Domingues MR, Bertoldi AD, Ricardo LIC, Müller WA,
Tornquist L, Martins RC, Murray J, Silveira MF, Crochemore-Silva
I, Curi Hallal P, Mielke GI. Effects of Regular Exercise During
Pregnancy on Early Childhood Neurodevelopment: The Physical
Activity for Mothers Enrolled in Longitudinal Analysis Randomized
Controlled Trial. J Phys Act Health. 2022 Mar 1;19(3):203-210. doi:
10.1123/jpah.2021-0477. Epub 2022 Feb 15. PMID: 35168196.
46. Goldstein RF, Abell SK, Ranasinha S, et al. Association of
Gestational Weight Gain With Maternal and Infant Outcomes: A
Systematic Review and Meta-analysis. JAMA. 2017;317(21):2207–
2225. doi:10.1001/jama.2017.3635
47. Berglund SK, García-Valdés L, Torres-Espinola FJ, Segura MT,
Martínez-Zaldívar C, Aguilar MJ, Agil A, Lorente JA, Florido J,
Padilla C, Altmäe S, Marcos A, López-Sabater MC, Campoy C;
PREOBE team. Maternal, fetal and perinatal alterations associated
with obesity, overweight and gestational diabetes: an observational
cohort study (PREOBE). BMC Public Health. 2016 Mar 1;16:207.
doi: 10.1186/s12889-016-2809-3. PMID: 26931143; PMCID:
PMC4774115.
48. Teede HJ, Bailey C, Moran LJ, Bahri Khomami M, Enticott J,
Ranasinha S, Rogozinska E, Skouteris H, Boyle JA, Thangaratinam
S, Harrison CL. Association of Antenatal Diet and Physical Activity-
Based Interventions With Gestational Weight Gain and Pregnancy
Outcomes: A Systematic Review and Meta-analysis. JAMA Intern
M e d . 2 0 2 2 F e b 1 ; 1 8 2 ( 2 ) : 1 0 6 - 1 1 4 . d o i : 1 0 . 1 0 0 1 /
jamainternmed.2021.6373. Erratum in: JAMA Intern Med. 2022 Oct
1;182(10):1108. doi: 10.1001/jamainternmed.2022.4410. PMID:
34928300; PMCID: PMC8689430.
49. Zhang, D.; Nagpal, T.S.; Silva-José, C.; Sánchez-Polán, M.; Gil-
Ares, J.; Barakat, R. Influence of Physical Activity during Pregnancy
on Birth Weight: Systematic Review and Meta-Analysis of
Randomized Controlled Trials. J. Clin. Med. 2023, 12, 5421. https://
doi.org/10.3390/jcm12165421
50. Watt, G., Hubbard, M. L., & Mottola, M. F. (2024). The association
of physical activity during pregnancy with birthweight extremes: a
scoping review. Journal of Science and Medicine in Sport. https://
doi.org/10.1016/j.jsams.2024.05.016
51. Li, J., Huang, D., Liang, J., Chen, J., Lei, L., Lin, M., … Liu, S.
(2023). Physical activity during pregnancy and adverse birth
outcome: a prospective cohort study in China. The Journal of
Maternal-Fetal & Neonatal Medicine, 36(1). https://doi.org/
10.1080/14767058.2022.2162819
52. Goławski, K.; Wojtyła, C. Impact of Physical Activity of Pregnant
Women on Obstetric Outcomes. Int. J. Environ. Res. Public Health
2022, 19, 12541. https://doi.org/10.3390/ijerph191912541
53. Beta J, Khan N, Khalil A, Fiolna M, Ramadan G, Akolekar R.
Maternal and neonatal complications of fetal macrosomia: systematic
review and meta-analysis. Ultrasound Obstet Gynecol. 2019
Sep;54(3):308-318. doi: 10.1002/uog.20279. Epub 2019 Aug 2.
PMID: 30938004.
54. Beta, J., Khan, N., Khalil, A., Fiolna, M., Ramadan, G., & Akolekar,
R. (2019). Maternal and neonatal complications of fetal macrosomia:
systematic review and meta-analysis. Ultrasound in Obstetrics &
Gynecology, 54(3), 308–318. https://doi.org/10.1002/UOG.20279
55. Raguž, M., Azinović, L., & Kolobarić, A. (2024). Aspects of the
macrosomic newborn in a one-year cohort. https://doi.org/
10.47960/3029-3316.2024.1.1.68
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