Background: Sleep impairment during pregnancy can impact quality of life and lead to excessive gestational weight gain, gestational diabetes mellitus, postpartum depression, and delivery complications. In nonpregnant adults, exercise improves sleep quality, duration, and onset latency. Purpose: To determine whether exercise performed during pregnancy improves sleep outcomes. Methods: A systematic review was conducted from January 2021 to July 2022 using online databases and hand searching (PROSPERO registration number: CRD42021243477). Randomized controlled trials (RCTs) available in English were eligible if the sample included pregnant women, the intervention included exercise and was compared to a standard care group, and sleep was included as an outcome measure. Mean differences and standardized mean differences were calculated to compare sleep outcomes across studies. Heterogeneity of results was calculated using I2 and risk of bias was assessed using the Cochrane Risk of Bias tool. Results: A total of 2578 articles were found using the search terms, and 7 studies met inclusion criteria (n = 839). Prenatal exercise reduced the amount of self-reported sleep disturbances (2 RCTs n = 115; instrumental variable [IV] −0.53, 95% confidence interval [CI] −0.90, −0.16, z = 2.79, P = .005) and improved sleep quality (3 RCTs n = 477; IV −0.48, 95% CI −0.61, −0.36) during pregnancy. Other sleep outcomes were not analyzed due to variability of measurements. Conclusion: Compared with not exercising, exercise during pregnancy improves sleep quality during pregnancy; however, the quality of existing evidence was low. Given the importance of sleep for health and well-being, more research is needed to determine the utility of exercise for improving sleep in pregnancy.
Background: Forty-five percent of pregnant women report moderate to severe low back and/or pelvic girdle pain (LBP/PGP) during pregnancy. Exercise, specifically muscular fitness training, is effective for the prevention and treatment of LBP/PGP in the general population. However, its efficacy during pregnancy is unknown. Objectives: The goal of this review is to examine the evidence supporting muscular fitness training for prevention and treatment of LBP/PGP during pregnancy. Study Design: A systematic review. Methods: A systematic review was conducted from February 2021 to June 2022 using online databases and hand searching. Randomized control trials were included if the population was pregnant women, the intervention was exercise training, the comparison was a nonexercise control group, and the outcome was LBP/PGP. A risk of bias analysis using the Cochran Risk of Bias (RoB) tool and quality assessment were performed using the GRADE method. The included articles were compiled into exercise types for comparison. Results: Of the 1707 articles found, 26 (n = 3946 pregnant women) were included in the final analysis after removing duplicates, articles that did not meet inclusion criteria, and articles unavailable in English. Seventeen out of 26 articles found that exercise during pregnancy had a positive effect on pain, but the quality of the studies ranged from very low to moderate. None of the included articles utilized strength training for muscular fitness, 2 used hypertrophy training, and the remaining articles utilized muscular endurance programs for muscular fitness. Conclusion: Strength and hypertrophy training for LBP/PGP during pregnancy is largely unknown and understudied; however, many other modes of exercise for muscular endurance improved pain. More research is warranted to determine the benefits of traditional strength and hypertrophy training for LBP/PGP management during pregnancy.
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