Antenatal exercise to improve outcomes in overweight or obese women: a systematic review

Background. Women who are overweight or obese during pregnancy are at increased risk of a number of adverse pregnancy outcomes. Objective. To review the literature systematically to assess the benefits and harms of an exercise intervention for pregnant women who are overweight or obese. Search strategy. A literature search of PUBMED, SCOPUS, the Cochrane Controlled Trials Register (CENTRAL) and the Australian and International Clinical Trials Registers was performed, as well as an additional hand search through bibliographies of various publications. There were no date or language restrictions. Selection criteria. Studies included were randomized controlled trials comparing supervised antenatal exercise intervention with routine standard antenatal care in women who were overweight or obese during pregnancy. The primary outcome was maternal gestational weight gain. The quality of each study was assessed utilizing standard Cochrane systematic review methodology. Data collection and analysis. Six randomized controlled trials and one quasi-randomized trial were identified and included, involving a total of 276 women who were overweight or obese during pregnancy. Results. Provision of a supervised antenatal exercise intervention was associated with lower gestational weight gain (five trials, 216 participants, mean difference of -0.36 kg, 95% confidence interval -0.64 to -0.09 kg) when compared with standard antenatal care. Conclusions. A monitored physical activity intervention appears to be successful in limiting gestational weight gain; however, the effect on maternal and infant health is less certain.