Leisure-Time Physical Activity in Pregnancy and Maternal-Child Health: A Systematic Review and Meta-Analysis of Randomiz
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SYSTEMATIC REVIEW
Leisure-Time Physical Activity in Pregnancy and Maternal-Child Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies Shana G. da Silva1 • Luiza I. Ricardo1 • Kelly R. Evenson2 • Pedro C. Hallal1
Ó Springer International Publishing Switzerland 2016
Abstract Background Evidence suggests that leisure-time physical activity (LTPA) during pregnancy is associated with a reduced risk of preeclampsia, gestational diabetes mellitus (GDM), and preterm birth. However, these results are inconsistent when comparing cohort studies and randomized controlled trials (RCTs). Objective The purpose of our study was to compare the associations between LTPA in pregnancy and maternal (GDM, preeclampsia, and weight gain during pregnancy) and child health outcomes (preterm birth, birthweight, and fetal growth) between RCTs and cohort studies. Methods We performed a systematic search in PubMed, Web of Science, and EBSCO up to 31 August 2015. Inclusion criteria for experimental studies required randomized trials with a control group and exposure to a physical activity structured program. The inclusion criteria for cohort studies required information on LTPA during pregnancy as an exposure and at least one maternal–child health outcome. We assessed the methodological quality of all studies and performed a meta-analysis to produce summary estimates of the effects using random models. Results We included 30 RCTs and 51 cohort studies. The meta-analysis of RCTs indicated that participation in LTPA was associated with lower weight gain during & Shana G. da Silva [email protected] 1
2
Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-38 piso, Bairro Centro, Pelotas, Rio Grande do Sul, CEP: 96020-220, Brazil, Pelotas 96020-220, Rio Grande do Sul, Brasil Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
pregnancy, lower likelihood of GDM, and lower likelihood of delivering a large-for-gestational-age infant. Cohort studies indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower risk of preterm delivery. Conclusions Our findings support the promotion of LTPA in pregnancy as a strategy to improve maternal and child health.
Key Points The aim of this systematic review and meta-analysis was to compare the associations between leisuretime physical activity (LTPA) in pregnancy on maternal and child health outcomes between randomized controlled trials and cohort studies. Our analysis revealed that women who were active during pregnancy were less likely to have excessive weight gain, to have gestational diabetes mellitus, and to deliver a preterm infant or a baby large for gestational age. The findings presented in our study provide additional evidence of the positive effects of LTPA during pregnancy and support the promotion of LTPA in pregnancy as a strategy to improve maternal and child health.
1 Intro
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