Exercise in Pregnancy and Children’s Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis
Open accessAbstract
Maternal metabolic health during the prenatal period is an established determinant of cardiometabolic disease risk. Many studies have focused on poor offspring outcomes after exposure to poor maternal health, while few have systematically appraised the evidence surrounding the role of maternal exercise in decreasing this risk. The aim of this study is to characterize and quantify the specific impact of prenatal exercise on children’s cardiometabolic health markers, at birth and in childhood. A systematic review of Scopus, MEDLINE, EMBASE, CENTRAL, CINAHL, and SPORTDiscus up to December 2017 was conducted. Randomized controlled trials (RCTs) and prospective cohort studies of prenatal aerobic exercise and/or resistance training reporting eligible offspring outcomes were included. Four reviewers independently identified eligible citations and extracted study-level data. The primary outcome was birth weight; secondary outcomes, specified a priori, included large-for-gestational age status, fat and lean mass, dyslipidemia, dysglycemia, and blood pressure. We included 73 of the 9804 citations initially identified. Data from RCTs was pooled using random effects models. Statistical heterogeneity was quantified using the I2 test. Analyses were done between June and December 2017 and the search was updated in December 2017. Fifteen observational studies (n = 290,951 children) and 39 RCTs (n = 6875 children) were included. Observational studies were highly heterogeneous and had discrepant conclusions, but globally showed no clinically relevant effect of exercise on offspring outcomes. Meta-analyzed RCTs indicated that prenatal exercise did not significantly impact birth weight (mean difference [MD] − 22.1 g, 95% confidence interval [CI] − 51.5 to 7.3 g, n = 6766) or large-for-gestational age status (risk ratio 0.85, 95% CI 0.51 to 1.44, n = 937) compared to no exercise. Sub-group analyses showed that prenatal exercise reduced birth weight according to timing (starting after 20 weeks of gestation, MD − 84.3 g, 95% CI − 142.2, − 26.4 g, n = 1124), type of exercise (aerobic only, MD − 58.7 g, 95% CI − 109.7, − 7.8 g; n = 2058), pre-pregnancy activity status (previously inactive, MD − 34.8 g, 95% CI − 69.0, − 0.5 g; n = 2829), and exercise intensity (light to moderate intensity only, MD − 45.5 g, 95% CI − 82.4, − 8.6 g; n = 2651). Fat mass percentage at birth was not altered by prenatal exercise (0.19%, 95% CI − 0.27, 0.65%; n = 130); however, only two studies reported this outcome. Other outcomes were too scarcely reported to be meta-analyzed. Prenatal exercise does not causally impact birth weight, fat mass, or large-for-gestational-age status in a clinically relevant way. Longer follow up of offspring exposed to prenatal exercise is needed along with measures of relevant metabolic variables (e.g., fat and lean mass). Protocol registration number: CRD42015029163 .
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In the systematic review, high-quality evidence was lacking because of variability in the type and duration of exercise, many studies combined exercise with dietary changes, and few evaluated health outcomes beyond birth weight in the offspring.
“However, in this review, high-quality evidence was lacking since there was variability in the type and duration of exercise in these studies; many studies combined exercise with dietary changes and few evaluated health outcomes beyond birth weight in the offspring.”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [140]
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Experimental — accuracy not yet measuredMaternal exercise during pregnancy is safe.
“While maternal exercise during pregnancy is safe, the systematic review concluded that there was insufficient evidence showing an effect of exercise during pregnancy on offspring metabolic health [140].”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [140]
A systematic review concluded that there was insufficient evidence showing an effect of exercise during pregnancy on offspring metabolic health.
“While maternal exercise during pregnancy is safe, the systematic review concluded that there was insufficient evidence showing an effect of exercise during pregnancy on offspring metabolic health [140].”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [140]
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- Authors
- Guillemette, L., Hay, J. L., Kehler, D. S., Hamm, N. C., Oldfield, C., McGavock, J. M., & Duhamel, T. A.
- Affiliations
- Children's Hospital Research Institute of Manitoba (CA)
- St. Boniface Hospital (CA)
- University of Manitoba (CA)
- Corresponding author
- Guillemette, Laetitia
- ORCID
- Venue
- Sports Medicine - Open
- Published
- 2018-08-02
- Volume
- 4
- Issue
- 1
- Pages
- 35-35
- ISSN
- 2198-9761 (ISSN-L)
- 2199-1170
- PMC
- PMC6070449
- OpenAlex
- W2885832469
- Cited by
- 18
- References
- 123
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 3 · 2020: 1 · 2019: 2
- FWCI
- 0.29
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Sports Medicine - Open (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Mspace (University of Manitoba) (submittedVersion)
- Funders
- Heart and Stroke Foundation of Canada
- Canadian Diabetes Association
- Research Manitoba
- University of Manitoba
- Lawson Foundation
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- exercise during pregnancy, maternal physical activity, cardiometabolic risk, children, birth weight, large for gestational age, dyslipidemia, dysglycemia, blood pressure, aerobic exercise, resistance training, maternal metabolic health, gestational diabetes mellitus, gestational hypertension, maternal alcohol consumption
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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