Table 5.
Systematic reviews and meta-analysis that assessed the effect physical activity interventions in pregnancy.
| Quality of reviews* | Systematic reviews | Studies included | Participants (n) | Types of intervention | Weighted mean difference or summary risk ratio (95% CI)/findings | Other findings/Contributors |
|---|---|---|---|---|---|---|
| PHYSICAL ACTIVITY INTERVENTIONS | ||||||
|
C (33/44, 75%) |
Streuling 2011 (SR+MA) (97) |
12 RCTs on GWG. | Any BMI | Light-moderate intensity supervised PA; average frequency 3 days/week; 20–60 min.; aerobic and/or resistance exercises. Duration: from 1st-2nd to 3rd trimester. |
Significant reduction of GWG (−0.61 kg; −1.17 to −0.06; I2 25%; 906 participants; 12 RCTs). |
No dose-dependent effect. |
|
D (30/44, 68%) |
da Silva 2017 (SR+MA) (99) |
18 RCTs on maternal/ infant outcomes (51 cohort studies excluded) | Any BMI | Moderate intensity supervised PA; average frequency 3 days/week; 20–70 min.; aerobic and/or resistance exercises. Duration: from 1st-2nd to 3rd trimester. |
Significant reduction of GWG (−1.11 kg; −1.53 to −0.69; I2 0%; 3,203 participants; 18 RCTs). |
Reduced RR of GDM (0.67, 0.49–0.92; I2 33%; 3,790 participants; 10 RCTs) and LGA (0.51, 95% CI 0.30–0.87; I2 0%; 1,499 participants; 4 RCTs). No effect on preeclampsia or preterm birth. Difficulties in attending regularly scheduled programs sessions. |
|
D (16/44, 36%) |
Perales 2016 (SR) (100) | 57 RCTs on maternal health or perinatal outcomes | Any BMI | 15 trials aerobic exercises; 4, resistance exercises; 30 combined; 8 counseling. 49 RCTs included supervised PA; 23 of them examined effects of supervised PA on GWG. Duration 12–18 week. |
Weak evidence for reduced GWG or for higher likelihood of GWG within IOM guidelines after aerobic or aerobic + resistance exercises or counseling. | Combined aerobic and resistance training: strong evidence for improved cardiorespiratory fitness and reduced urinary incontinence. Weak evidence for reduced GDM, pregnancy-induced HTA, duration of labor or cesarean section, and macrosomia after intervention. No adverse outcome. |
|
D (28/44, 64%) |
Elliott-Sale 2015 (SR+MA) (98) |
3 RCTs on GWG, from 1990 only | Any BMI | Light-moderate intensity supervised PA; combined aerobic and resistance exercises; frequency 3–5 days/week; 45–60 min. Duration: 12–33 week. | Significant reduction of GWG (−2.22 kg; −3.14 to −1.3, I2 0%; 214 participants; 3 RCTs). | Methodological quality varied considerably across trials. Small number of RCTs. |
BMI, Body mass index; CI, confidence interval; GWG, gestational weight gain; GDM, gestational diabetes mellitus; HIC, high income countries; IOM, Institute of Medicine; LGA, large for gestational age; LMIC, low and middle income countries; MA, meta-analysis; OW, overweight; OB, obesity; PA, physical activity; PPWR, postpartum weight retention; SGA, small for gestational age; RCT, randomized controlled trial; RR, risk ratio; SR, systematic review; wk, week.
The quality of systematic reviews and meta-analysis was assessed using the R-AMSTAR Checklist (ranking, score). When available, the information on the quality of evidence that was reported by authors is indicated in the findings' columns.