Exercise and physical activity in the prevention of pre‐eclampsia: systematic review

Abstract

Exercise and physical activity have been studied and suggested as a way to reduce or minimize the effects of pre-eclampsia. Our aim was to evaluate the association between exercise and/or physical activity and occurrence of pre-eclampsia. We conducted electronic searches without year of publication and language limitations. This was a systematic review designed according to PRISMA. Different databases accessed were as follows: PubMed®; Latin-American and Caribbean Literature in Health Sciences (LILACS); Scientific Electronic Library On-line (SciELO); Physiotherapy Evidence Database (PEDro); and ISI web of Knowledge(SM) . The Medical Subject Headings (MeSH) were as follows: ("exercise" OR "motor activity" OR "physical activity") AND ("pre-eclampsia" OR "eclampsia" OR "hypertension, pregnancy-induced"). Inclusion criteria were studies conducted in adults who were engaged in some physical activity. The selection and methodological evaluation were carried out by two independent reviewers. Risk assessment was made by the odds ratio (OR) and incidence of pre-eclampsia in the population who performed physical activity/exercise. A total of 231 articles were found, 214 of which were excluded based on title and full-text, so that 17 remained. Comparison of six case-control studies showed that physical activity had a protective effect on the development of pre-eclampsia [OR 0.77, 95% confidence interval (CI) 0.64-0.91, p < 0.01]. The 10 prospective cohort studies showed no significant difference (OR 0.99, 95% CI 0.93-1.05, p= 0.81). The only randomized clinical trial showed a protective effect on the development of pre-eclampsia in the stretching group (OR 6.34, 95% CI 0.72-55.37, p= 0.09). This systematic review indicates a trend toward a protective effect of physical activity in the prevention of pre-eclampsia.

Impact of Physical Stretching Exercise on Feto-Maternal Outcomes Among Mild Preeclamptic Pregnant Women in Egypt

“…In a recent systematic review of randomized controlled trial, case control and cohort studies regarding exercise and physical activity in the prevention of worsening preeclampsia performed by health pregnant women showed a possible protective effect of leisure time physical activity in the worsening of preeclampsia [37].…”

Recomendações para a prática de exercício físico na gravidez: uma revisão crítica da literatura

“…Em gestante de baixo risco, alguns estudos observacionais sugerem que a prática regular de exercício antes e no início da gestação está associada à diminuição do risco de desenvolvimento de pré-eclâmpsia 12,25 . Uma metaná-lise, publicada em 2012, mostrou que mulheres ativas antes da gestação têm 44% menos chance de desenvolver pré-eclâmpsia, com odds ratio (OR) de 0,56, IC95% 0,41-0,76 e p<0,01, enquanto que gestantes que se envolvem em atividades físicas têm 23% menos chance (OR=0,77; IC95% 0,64-0,91; p<0,01) 25 .…”

“…Associado a isso, o repouso prolongado no leito aumenta de modo consistente o risco de trombose venosa 24 . Para gestantes com hipertensão arterial crônica com controle pré-natal e pressórico adequados, a prática 25 . Gestantes com hipertensão arterial crônica controlada ou com antecedente pré-eclâmpsia que realizaram mais de dez sessões de exercício em bicicleta estacionária durante a gestação, quando comparadas a um grupo controle, apresentaram melhores resultados perinatais.…”

Preeclampsia and Maternal Cardiovascular Disease: Consequence or Predisposition?

“…The effects of nutritional interventions are also limited [132], although some beneficial effects of antiplatelet agents, primarily low-dose aspirin and calcium supplementation have been noted [133]. Some beneficial effects of exercise in previously preeclamptic women have also been noted, with the results of some studies suggesting that exercise may be potentially helpful for disease prevention [134,135,136]. …”