Leisure-Time Physical Activity in Pregnancy and Maternal-Child Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies.
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 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.
Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3º piso, Bairro Centro, Pelotas, Rio Grande do Sul, CEP: 96020-220, Brazil, Pelotas, 96020-220, Rio Grande do Sul, Brasil. sginar@gmail.com.
Shana G
SG
da Silva
Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3º piso, Bairro Centro, Pelotas, Rio Grande do Sul, CEP: 96020-220, Brazil, Pelotas, 96020-220, Rio Grande do Sul, Brasil.
Luiza I
LI
Ricardo
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Kelly R
KR
Evenson
Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3º piso, Bairro Centro, Pelotas, Rio Grande do Sul, CEP: 96020-220, Brazil, Pelotas, 96020-220, Rio Grande do Sul, Brasil.
Pedro C
PC
Hallal
D002648:Child; D000067576:Child Health; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000517:prevention & control; D015444:Exercise; D005260:Female; D006801:Humans; D007899:Leisure Activities; D050177:Overweight / Q000517:prevention & control; D011225:Pre-Eclampsia / Q000517:prevention & control; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D016032:Randomized Controlled Trials as Topic; D015430:Weight Gain