Table 3.

Effects of exposure to baby swimming programs on infants’ development.

1st Author, Year	Research Aim and Design	Results	Risk of BIAS
Sigmundsson, 2010 [38]	Effects of baby swimming programs attendance on infants’ (2–7 months) subsequent motor abilities. Motor abilities of 19 four-years-old children who attended baby swimming programs during first year of life (mostly between 2 and 7 months of age) were tested using Standardized Movement Assessment Battery for Children and compared with an age-matched control group of 19 who did not attend baby swimming programs.	Performance in prehension, ball skill sub-test (p < 0.05), and static balance, one-leg balance sub-test (p < 0.017) were better in the swimming group. Baby swimming programs promote better motor skill development specifically in provision of vestibular stimulation and eye–hand coordination.	** Confounding Criteria for inclusion in the sample Measurement of exposure
Dias, 2013 [39]	Effect of baby swimming programs attendance on infants’ (7–9 months of age) gross motor development. Gross motor skills were accessed using Alberta Infant Motor Scale (AIMS) before and after four months of weekly playful baby swimming classes with babies (N = 6) and compared with a control (N = 6).	Results revealed a difference between pre- and post-tests (p < 0.02) for both groups, with Cohen’s r = 0.90 in experimental group indicating a larger effect than observed in the control group (Cohen’s r = 0.69); and a larger effect size in the experimental group (r = 0.47) of the change in comparison to the control group (r = 0.06). No differences between groups were observed. Baby swimming programs attendance facilitated the development of infants’ gross motor skills; however, the sample size was too small to generate significant differences.	* Confounding
Pereira, 2011 [40]	Effect of participating in baby swimming programs and program participation period in infants’ (1–18 months of age) motor development. Motor development, accessed using Alberta Infant Motor Scale (AIMS), was tested on a group of infants who participated in a program of aquatic activities (N = 40), and compared with a matched control group of non-swimmers (N = 40).	Motor development of non-swimming child was lower (Chi2 = 16.59; p < 0.001). A significant correlation was found (rho = 0.42; p = 0.012) between the time attending baby swimming program and percentile values: longer exposure was related with higher percentile values. Baby swimming program attendance and participation period had positive influence in infants’ motor development.	** Confounding
Borioni, 2022 [41]	Effect of baby swimming programs attendance on infant’ (0–3 years of age) motor and cognitive development. Peabody Developmental Motor Scale was applied to assess 0–3 years old gross motor skills (GM), fine motor skills (FM) and total motor skills (TM), and core tests of executive functions was applied to access Cognitive development (delayed response for working memory, object retrieval for inhibition and A-not-B for response shifting) before and after 10 weekly 45 min sessions of baby swimming intervention (N = 12), as well as control group (N = 15).	Motor development: For the intervention group, post-test of GM, FM, and TM scores were higher than pre-test scores (GM: Z = −2.98, p = 0.003; FM: Z = −2.97, p = 0.003; TM: Z = −3.08, p = 0.002). For the control group no significant different between pre and post-test were observed. GM, FM, and TM scores were higher for intervention group (GM: U = 35.50, n1 = 12, n2 = 15, p = 0.006; FM: U = 25.50, n1 = 12, n2 = 15, p = 0.001; TM: U = 25.00, n1 = 12; n2 = 15, p = 0.001). Cognitive performance: No differences between pre and post-test were found in either group. A marginal significant change in inhibition speed (Z = −2.12, p = 0.034), response shifting accuracy (Z = −1.87, p = 0.062) and in perseveration errors (Z = −2.00, p = 0.046) were observed on intervention group (given the adjusted p < 0.016 for three comparisons). Baby swimming programs attendance may benefit motor development and early executive function skills.	* Confounding
Blystad, 2022 [42]	Effect of extra motor stimulation in the form of baby swimming on development of visual motion perception during first year of life. Brain responses to visual motion, accessed using EEG recordings and onset of self-produced locomotion (documented with parental video records) were obtained on a longitudinal study design at the ages of 4–5 months and 9–12 months on infants that received extra stimulation in the form of baby swimming (N = 10), infants that received a traditional Western upbringing (N = 10), and preterm infants (N = 10). Infants were presented with visual motion on a large screen simulating forward optic flow, reversed optic flow, and random visual motion.	Infants receiving extra motor stimulation and infants in the control group showed developmental improvements in visual motion perception, with a greater improvement for intervention group. Extra-stimulated infants also showed significantly shorter N2 latencies for visual motion and started to locomote at a younger age than the control and preterm groups. Baby swimming programs attendance during first year of life promotes accelerated developmental improvements of visual motion perception.	* Confounding
Leo, 2022 [43]	Effect of baby swimming programs on infants’ (6–10 months of age) motor development Motor development was assessed using Peabody Developmental Motor Scale-2 in a group of infants attending baby swimming programs (N = 14) and a control group (N = 14).	Better scores on measures of reflexes (t = −2.2, p < 0.05), grasping (t = −3.8, p < 0.001), fine-motor quotient (t = −3.4, p < 0.01), and total-motor quotient (t = −2.4, p < 0.05) were observed in the intervention group. Baby swimming programs positively influence early motor development in infants and toddlers.	** Measurement of exposure

Quality analysis tool: * ROBINS-I and ** JBI.