The effect of exercise on maternal complications and birth outcomes in overweight or obese pregnant women: a meta-analysis

Abstract

Background: Overweight and obesity can increase the risk for certain adverse obstetric outcomes. Exercise may reduce these risks by promoting weight loss or preventing excessive weight gain. Therefore, this study aims to evaluate the effect of exercise therapy on pregnancy complications and birth outcomes in overweight or obese pregnant women through a meta-analysis.Methods: We searched the electronic databases PubMed, Cochrane Library, Embase, and Web of Science for studies on the effects of exercise therapy on pregnancy complications and birth outcomes in overweight or obese pregnant women. The data were analyzed using Stata software for meta-analysis.Results: A total of 1,709 pregnant women who met the eligibility criteria were included across 13 studies.The meta-analysis demonstrated a significant difference between the exercise group and the control group in regards to gestational weight gain [GWG; standard mean difference (SMD): −0.21, 95% confidence interval (CI): −0.32 to −0.10)] and gestational hypertension [GH; risk ratio (RR) and 95% CI were 0.53 (0.32-0.88)]. Contrastingly, no significant differences were found between the 2 groups in terms of the other evaluation indicators, including gestational length at delivery, Apgar score at 1 minute and 5 minutes, gestational diabetes, cesarean delivery, preterm delivery, preeclampsia, macrosomia, and neonatal asphyxia. Conclusions:The results of this study suggest that exercise can reduce the risk of GWG and the occurrence rate of GH in overweight or obese pregnant women, however, exercise had no effect on birth outcomes.

The effect of exercise on the prevention of gestational hypertension in obese and overweight pregnant women: An updated meta-analysis

“…This finding was inconsistent with the previous meta-analysis by Muhammad et al ( 27 ) and by Du et al ( 28 ), they both found that exercise intervention would not reduce the risk of GH in overweight/obese pregnant women. However, the meta-analysis by Xing et al ( 26 ) yielded a similar conclusion to our study. In the previous meta-analysis, the searching process may not have been comprehensive and therefore the results obtained do not seem to be very accurate.…”

“…In the previous meta-analysis, the searching process may not have been comprehensive and therefore the results obtained do not seem to be very accurate. Comparing this study with the previous meta-analyses ( 26 – 28 ), in this study, we conducted a more detailed and comprehensive search, included more articles, had a larger sample size, and therefore had greater statistical validity and more feasible results.…”

“…However, the controversy of whether physical exercise (PE) may reduce the risk of GH in overweight and obese pregnant women always exists. In a previously published meta-analysis by Xing et al ( 26 ), it was noted that exercise intervention reduced the risk of GH in overweight/obese pregnant women, while in the meta-analysis by Muhammad et al ( 27 ) and meta-analysis by Du et al ( 28 ), contrary conclusions were proposed. They found that PE was associated with a statistically non-significant decreased risk of GH.…”

Associations Between Gestational Weight Gain and Adverse Birth Outcomes: A Population-Based Retrospective Cohort Study of 9 Million Mother-Infant Pairs

“…Another multi-racial population-based study of 181,948 women in Washington State suggested that maternal GWG (below or above guidelines) was not associated with Apgar score <7 at 5 min for those with ethnicity/race of white, black, east Asian, Hispanic, south Asian or other (all P > 0.05), except for Native American (below guidelines: OR = 3.06, 95%CI = 1.06–8.85) ( 18 ). In addition, two other studies with relatively small sample sizes ( n = 1,709 and 1,000, respectively) did not report any association between GWG below or above guidelines and low Apgar score ( 19 , 20 ). With the largest sample size on this topic to date, our study supported higher odds of low Apgar score for those with GWG above or below the guidelines.…”

“…To draw a more convincing and generalizable conclusion, our study included the largest sample size of the U.S. population to date on this topic, using unified definitions of maternal GWG categories and infant birth outcomes, and adjusting for a range of potential confounding factors. To our knowledge, few studies have assessed the associations between maternal GWG and low Apgar score, with contradictory results (17)(18)(19)(20). A population-based retrospective cohort study of 101,259 U.S. women with chronic hypertension showed that women with GWG ≥20 lbs (i.e., 9072.0 g) above IOM guidelines were at increased odds of 5-min Apgar score <7 (OR = 1.29, 95% CI = 1.13-1.47), whereas those with GWG of 1-19 lbs (i.e., 453.6-8618.4 g) above guidelines or below guidelines were not at higher odds of low Apgar score (1-19 lbs above guideline: OR = 1.04, 95% CI = 0.93-1.17; below guideline: OR = 0.97, 95% CI = 0.84-1.11) (17).…”