Assessing physical fitness during pregnancy: validity and reliability of fitness tests, and relationship with maternal and neonatal health-related outcomes. A systematic review

Abstract

Background: Physical fitness (PF) is a powerful marker of health throughout the lifespan. In pregnant women, higher PF is associated with better maternal and fetal health, better delivery outcomes and earlier postpartum recovery. The assessment of PF during pregnancy requires special considerations to preserve fetal and maternal health; thus, providing a compilation of the most frequently used fitness tests, and assessing their validity, reliability, and association with maternal and neonatal health-related outcomes is of scientific and clinical interest. Objectives: To systematically review studies evaluating one or more components of PF in pregnant women, to answer two research questions: 1) What fitness tests have been previously employed in pregnant women? and 2) What is the validity and reliability of these tests and their relationship with health-related outcomes? Data Sources: PubMed and Web of Science. Methods: Two independent reviewers systematically examined the articles in each database. The information from the included articles was summarized by a single researcher. Results: A total of 149 articles containing a sum of 191 fitness tests were included. Among the 191 fitness tests, 99 (i.e.,52%) assessed cardiorespiratory fitness through 75 different protocols, 28 (15%) assessed muscular fitness through 16 different protocols, 14 (7%) assessed flexibility through 13 different protocols, 45 (24%) assessed balance through 40 different protocols, 2 assessed speed with the same protocol and 3 were multidimensional tests using one protocol. A total of 19 articles with 23 tests (13%) assessed either validity (n=4), reliability (n=6), or the relationship of PF with health-related outcomes (n=16). Conclusion: PF during pregnancy has been assessed through a wide variety of protocols, mostly lacking validity and reliability data.

Physical Fitness Assessment during Pregnancy

“…Despite clinical and public health relevance of assessing PF during pregnancy, a specific fitness battery of tests for this purpose does not exist. In fact, a wide variety of fitness tests have been used to assess PF during pregnancy, and a compilation of these tests has recently been published (25). A compendium like this can help exercise professionals administer assessments most rel-evant to their clients.…”

“…Common PF tests used during pregnancy are reviewed herein (Table 2) based on their reliability, validity, and frequency of use. Current research demonstrates a total of 191 fitness tests, using 149 different protocols, have been used to assess PF during pregnancy (25), and a brief summary is presented. The component most frequently assessed is CRF; however, there are 75 different protocols to assess CRF.…”

“…However, there is no consensus on which fitness tests should be used to assess PF in pregnant individuals. Moreover, the validity and reliability of many of the tests used to assess PF during pregnancy is unknown (25).…”