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Quality in Sport

The Impact of Physical Activity During Pregnancy on Maternal and Fetal Outcomes: A Literature Review
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The Impact of Physical Activity During Pregnancy on Maternal and Fetal Outcomes: A Literature Review

Authors

  • Natalia Padula Student https://orcid.org/0009-0001-6034-5065
  • Tomasz Pluszyński Medical University of Silesia, Faculty of Medical Sciences in Katowice https://orcid.org/0009-0005-6380-7789
  • Karol Piotrowski Medical University of Silesia in Katowice https://orcid.org/0009-0004-4675-5123
  • Małgorzata Jerczak Medical University of Silesia in Katowice https://orcid.org/0009-0001-0545-2466
  • Iga Piórkowska Medical University of Silesia In Katowice https://orcid.org/0009-0006-2625-3593
  • Mikołaj Polewka Medical University of Silesia https://orcid.org/0009-0003-0721-4589
  • Aleksandra Polańska Medical University of Silesia https://orcid.org/0009-0001-7581-0900
  • Kacper Paczosa Medical University of Silesia in Katowice, Poland https://orcid.org/0009-0000-8143-5409
  • Filip Przybył Medical University of Silesia https://orcid.org/0009-0009-0765-1782

DOI:

https://doi.org/10.12775/QS.2026.57.72480

Keywords

physical activity, resistance training, activity during pregnancy, postpartum

Abstract

Background. Physical activity during pregnancy is widely recognized as a key determinant of maternal and fetal health. Levels and patterns of physical activity often change across trimesters due to physiological, metabolic, and psychological adaptations. Given the dynamic nature of pregnancy, a comprehensive synthesis of current evidence on the effects and safety of physical activity across all trimesters is warranted to support trimester-specific recommendations and optimize maternal and neonatal outcomes.

Aim. The aim of this review is to synthesize current evidence on physical activity throughout the entire course of pregnancy. Particular attention is given to trimester-specific patterns of physical activity, associated maternal and fetal health outcomes.

Material and Methods

A systematic literature review was conducted across international databases, encompassing meta-analyses, randomized controlled trials, cohort studies, and official guidelines from scientific societies. Key publications evaluating the physiological, biomechanical, and epigenetic effects of physical exertion were selected.

Results. The accumulated evidence unequivocally demonstrates that regular physical exertion lowers the risk of gestational diabetes (by approx. 38%), pregnancy-induced hypertension (by approx. 58%), and fetal macrosomia, without negatively affecting the hemodynamic parameters of the umbilical artery. Studies from 2024-2025 confirm the safety of high-intensity training and submaximal resistance training. Furthermore, maternal exercise has been shown to have a stimulating effect on fetal epigenetic programming and neurogenesis, as well as a fundamental role of early mobilization in reducing symptoms of postpartum depression and pelvic floor dysfunction.

Conclusion. Physical activity during pregnancy and the postpartum period is not only safe but constitutes a key prophylactic and therapeutic mechanism.

References

Cilar Budler, L., & Budler, M. (2022). Physical activity during pregnancy: a systematic review for the assessment of current evidence with future recommendations. BMC sports science, medicine & rehabilitation, 14(1), 133. https://doi.org/10.1186/s13102-022-00524-z

Angelino, A., Colacurci, D., Borrelli, P., Tramontano, A. L., Niccolini, L., Giudice, M., Calvanese, M., Mennitti, C., Scudiero, O., Mappa, I., Derme, M., Rizzo, G., Guida, M., Maruotti, G. M., & Sarno, L. (2026). Adherence to physical activity during the first trimester of pregnancy: a study from Southern Italy. Archives of gynecology and obstetrics, 313(1), 49. https://doi.org/10.1007/s00404-026-08320-7

Santos, P. C., Leirós-Rodríguez, R., Abreu, S., Ferreira, M., Alves, O., & Mota, J. (2022). Physical activity during pregnancy and its effects on neonatal outcomes. Placenta, 128, 9–17. https://doi.org/10.1016/j.placenta.2022.08.009

Ehrlich, S. F., Ferrara, A., Hedderson, M. M., Feng, J., & Neugebauer, R. (2021). Exercise During the First Trimester of Pregnancy and the Risks of Abnormal Screening and Gestational Diabetes Mellitus. Diabetes care, 44(2), 425–432. https://doi.org/10.2337/dc20-1475

Lu, Q., Yan, S. J., Chen, H. J., Pan, X. F., Ye, Y. X., Song, X. Y., Wang, R. X., & Lyu, C. Z. (2023). The relationship between physical activity in early pregnancy and hypertensive disorders of pregnancy: a cohort study in Chinese women. World journal of emergency medicine, 14(3), 204–208. https://doi.org/10.5847/wjem.j.1920-8642.2023.047

Zhang, J., Xiao, Y., Bai, S., Lin, S., Du, S., & Wang, Z. (2024). The Association Between Exercise During Pregnancy and the Risk of Preterm Birth. International journal of women's health, 16, 219–228. https://doi.org/10.2147/IJWH.S447270

Mei, Q., Chen, X., Liu, L., & Xiao, G. (2024). An investigation into the correlation between early-to-mid pregnancy exercise combined with cognitive behavioral therapy and anxiety levels and quality of life in patients. The journal of obstetrics and gynaecology research, 50(3), 381–388. https://doi.org/10.1111/jog.15858

Zhou, T., Lin, Y., Ding, Y., & Wang, N. (2025). Exploring Factors Influencing Physical Inactivity During the First Trimester of Pregnancy: A Convergent Mixed-Methods Study. Nursing open, 12(11), e70310. https://doi.org/10.1002/nop2.70310

Shen, Y., Wang, Y., & Huang, P. (2025). Effects of exercise during pregnancy on maternal and newborn outcomes. BMC pregnancy and childbirth, 25(1), 1158. https://doi.org/10.1186/s12884-025-08285-6

He, Z., Yuan, Y., Zhang, L., Niu, W., Liu, L., Chen, B., & Wang, X. (2026). The metabolic implications of maternal exercise: effects on pregnant women and their offspring. Frontiers in Nutrition.

Prevett, C., Gingerich, J., Sivak, A., & Davenport, M. H. (2025). Resistance training in pregnancy: systematic review and meta-analysis of pregnancy, delivery, fetal and pelvic floor outcomes and call to action. British journal of sports medicine, 59(16), 1173–1182. https://doi.org/10.1136/bjsports-2024-109123

Moolyk, A. N., Wilson, M. K., Matenchuk, B. A., Bains, G., Gervais, M. J., Wowdzia, J. B., & Davenport, M. H. (2025). Maternal and fetal responses to acute high-intensity resistance exercise during pregnancy. British journal of sports medicine, 59(3), 159–166. https://doi.org/10.1136/bjsports-2024-108804

Schulz, J. M., & Thornton, J. S. (2024). Infographic. Return to activity/sport postpartum: a summary of current recommendations. British journal of sports medicine, 58(9), 511–512. https://doi.org/10.1136/bjsports-2023-107856

Beamish, N. F., Davenport, M. H., Ali, M. U., Gervais, M. J., Sjwed, T. N., Bains, G., Sivak, A., Deering, R. E., & Ruchat, S. M. (2025). Impact of postpartum exercise on pelvic floor disorders and diastasis recti abdominis: a systematic review and meta-analysis. British journal of sports medicine, 59(8), 562–575. https://doi.org/10.1136/bjsports-2024-108619

Lee R, Thain S, Tan LK, Teo T, Tan KH. Asia-Pacific consensus on physical activity and exercise in pregnancy and the postpartum period. BMJ Open Sport & Exercise Medicine. 2021;7:e000967. https://doi.org/10.1136/bmjsem-2020-000967

Davenport, M. H., Ruchat, S. M., Jaramillo Garcia, A., Ali, M. U., Forte, M., Beamish, N., Fleming, K., Adamo, K. B., Brunet-Pagé, É., Chari, R., Lane, K. N., Mottola, M. F., & Neil-Sztramko, S. E. (2025). 2025 Canadian guideline for physical activity, sedentary behaviour and sleep throughout the first year post partum. British journal of sports medicine, bjsports-2025-109785. Advance online publication. https://doi.org/10.1136/bjsports-2025-109785

Quality in Sport

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Published

2026-06-07

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PADULA, Natalia, PLUSZYŃSKI, Tomasz, PIOTROWSKI, Karol, JERCZAK, Małgorzata, PIÓRKOWSKA, Iga, POLEWKA, Mikołaj, POLAŃSKA, Aleksandra, PACZOSA, Kacper and PRZYBYŁ, Filip. The Impact of Physical Activity During Pregnancy on Maternal and Fetal Outcomes: A Literature Review. Quality in Sport. Online. 7 June 2026. Vol. 57, p. 72480. [Accessed 10 June 2026]. DOI 10.12775/QS.2026.57.72480.
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Vol. 57 (2026)

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Copyright (c) 2026 Natalia Padula, Tomasz Pluszyński, Karol Piotrowski, Małgorzata Jerczak, Iga Piórkowska, Mikołaj Polewka, Aleksandra Polańska, Kacper Paczosa, Filip Przybył

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