The Effects of Exercise During Pregnancy on Maternal and Fetal Health: A Narrative Review

Abstract

Pregnancy is a multidimensional period characterized by significant physiological, metabolic, and psychological changes in the female body. During this process, lifestyle factors, particularly physical activity, play a critical role in determining both maternal and fetal health outcomes. This review aims to comprehensively examine the role of exercise during pregnancy in terms of maternal physiological adaptation, metabolic health, psychological well-being, labor outcomes, and fetal development, based on current literature. The findings in the literature indicate that regular, moderate-intensity physical activity can reduce the risk of complications such as gestational diabetes, pregnancy-induced hypertension, and excessive gestational weight gain. Additionally, exercise has been reported to enhance cardiovascular capacity, support musculoskeletal function, and improve psychological well-being. From an obstetric perspective, exercise may increase the likelihood of vaginal delivery and support postpartum recovery. Moreover, current evidence suggests that appropriately designed exercise programs do not have adverse effects on fetal development and can be considered safe. Overall, exercise during pregnancy appears to provide multidimensional benefits for both maternal and fetal health. However, it is essential that exercise programs are tailored according to individual characteristics and pregnancy conditions. In this context, prenatal exercise can be regarded as a safe and effective component of a healthy lifestyle during pregnancy.

Keywords

• Gestational Diabetes
• Maternal Health
• Physical Activity
• Pregnancy
• Prenatal Exercise

Hamilelikte Egzersizin Anne ve Fetal Sağlık Üzerindeki Etkileri: Anlatımsal Bir Derleme

Abstract

Hamilelik, kadın vücudunda önemli fizyolojik, metabolik ve psikolojik değişikliklerin yaşandığı çok yönlü bir dönemdir. Bu süreçte yaşam tarzı faktörleri, özellikle de fiziksel aktivite, hem annenin hem de fetüsün sağlık durumunu belirlemede kritik bir rol oynar.Bu derleme, mevcut literatüre dayanarak hamilelik sırasında egzersizin anne adayının fizyolojik adaptasyonu, metabolik sağlığı, psikolojik iyilik hali, doğum sonuçları ve fetüsün gelişimi üzerindeki rolünü kapsamlı bir şekilde incelemek amacıyla hazırlanmıştır.Literatürdeki bulgular, düzenli ve orta yoğunlukta fiziksel aktivitenin gebelik diyabeti, gebelik kaynaklı hipertansiyon ve aşırı gebelik kilo alımı gibi komplikasyon riskini azaltabileceğini göstermektedir. Ayrıca, egzersizin kardiyovasküler kapasiteyi artırdığı, kas-iskelet sisteminin işlevini desteklediği ve psikolojik sağlığı iyileştirdiği bildirilmiştir. Doğum bilimi açısından bakıldığında, egzersiz vajinal doğum olasılığını artırabilir ve doğum sonrası iyileşmeyi destekleyebilir.Moreover, current evidence suggests that appropriately designed exercise programs do not have adverse effects on fetal development and can be considered safe. Overall, exercise during pregnancy appears to provide multidimensional benefits for both maternal and fetal health. However, it is essential that exercise programs are tailored according to individual characteristics and pregnancy conditions. In this context, prenatal exercise can be regarded as a safe and effective component of a healthy lifestyle during pregnancy.Bu bağlamda, doğum öncesi egzersiz, hamilelik döneminde sağlıklı bir yaşam tarzının güvenli ve etkili bir parçası olarak değerlendirilebilir.

Keywords

• Gebelik Diyabeti
• Anne Sağlığı
• Fiziksel Aktivite
• Hamilelik
• Doğum Öncesi Egzersiz

References

1. American College of Obstetricians and Gynecologists. (2020). Physical activity and exercise during pregnancy and the postpartum period. Obstetrics & Gynecology, 135(4), e178–e188. https://doi.org/10.1097/AOG.0000000000003772
2. Artal, R., & O’Toole, M. (2003). Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. British Journal of Sports Medicine, 37(1), 6–12. https://doi.org/10.1136/bjsm.37.1.6
3. Aune, D., Saugstad, O. D., Henriksen, T., & Tonstad, S. (2014). Physical activity and the risk of preeclampsia: A systematic review and meta-analysis. Epidemiology, 25(3), 331–343. https://doi.org/10.1097/EDE.0000000000000036
4. Barakat, R., Pelaez, M., Lopez, C., Montejo, R., & Coteron, J. (2012). Exercise during pregnancy reduces the rate of cesarean and instrumental deliveries: Results of a randomized controlled trial. The Journal of Maternal-Fetal & Neonatal Medicine, 25(11), 2372–2376. https://doi.org/10.3109/14767058.2012.696165
5. Birsner, M. L., & Gyamfi-Bannerman, C. (2020). Physical activity and exercise during pregnancy and the postpartum period: ACOG Committee Opinion Summary, Number 804. Obstetrics & Gynecology, 135(4), e178–e188. https://doi.org/10.1097/AOG.0000000000003772
6. Butte, N. F. (2000). Carbohydrate and lipid metabolism in pregnancy: Normal compared with gestational diabetes mellitus. The American Journal of Clinical Nutrition, 71(5 Suppl), 1256S–1261S. https://doi.org/10.1093/ajcn/71.5.1256S
7. Clapp, J. F. (2006). Influence of endurance exercise and diet on human placental development and fetal growth. Placenta, 27(6–7), 527–534. https://doi.org/10.1016/j.placenta.2005.07.010
8. Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K., & Tate, D. F. (2016). Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065–2079. https://doi.org/10.2337/dc16-1728

9. Cremona, A., O’Gorman, C., Cotter, A., Saunders, J., & Donnelly, A. (2018). Effect of exercise modality on markers of insulin sensitivity and blood glucose control in pregnancies complicated with gestational diabetes mellitus: A systematic review. Obesity Science & Practice, 4(5), 455–467. https://doi.org/10.1002/osp4.283
10. Daley, A. J., MacArthur, C., & Winter, H. (2007). The role of exercise as a treatment for postnatal depression: A review of the literature. Journal of Midwifery & Women’s Health, 52(1), 56–62. https://doi.org/10.1016/j.jmwh.2006.08.017
11. Davenport, M. H., Ruchat, S.-M., Poitras, V. J., Garcia, A. J., Gray, C. E., Barrowman, N., Skow, R. J., Meah, V. L., Riske, L., Sobierajski, F., James, M., Nagpal, T., Marchand, A.-A., Nuspl, M., Slater, L. G., Weeks, A., Adamo, K. B., Davies, G. A., & Tremblay, M. S. (2018). Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: A systematic review and meta-analysis. British Journal of Sports Medicine, 52(21), 1367–1375. https://doi.org/10.1136/bjsports-2018-099355 Dipla, K., Zafeiridis, A., Mintziori, G., Boutou, A. K., Goulis, D. G., & Hackney, A. C. (2021). Exercise as a therapeutic intervention in gestational diabetes mellitus. Endocrines, 2(2), 65–78. https://doi.org/10.3390/endocrines2020007
12. Di Mascio, D., Magro-Malosso, E. R., Saccone, G., Marhefka, G. D., & Berghella, V. (2016). Exercise during pregnancy in normal-weight women and risk of preterm birth: A systematic review and meta-analysis of randomized controlled trials. American Journal of Obstetrics and Gynecology, 215(5), 561–571. https://doi.org/10.1016/j.ajog.2016.06.014
13. Evenson, K. R., Barakat, R., Brown, W. J., Dargent-Molina, P., Haruna, M., Mikkelsen, E. M., Mottola, M. F., Owe, K. M., Rousham, E. K., & Yeo, S. (2014). Guidelines for physical activity during pregnancy: Comparisons from around the world. American Journal of Lifestyle Medicine, 8(2), 102–121. https://doi.org/10.1177/1559827613498204
14. Institute of Medicine. (2009). Weight gain during pregnancy: Reexamining the guidelines. National Academies Press. https://doi.org/10.17226/12584
15. Magro-Malosso, E. R., Saccone, G., Di Tommaso, M., Roman, A., & Berghella, V. (2017). Exercise during pregnancy and risk of gestational hypertensive disorders: A systematic review and meta-analysis. Acta Obstetricia et Gynecologica Scandinavica, 96(8), 921–931. https://doi.org/10.1111/aogs.13151
16. Mottola, M. F., Giroux, I., Gratton, R., Hammond, J.-A., Hanley, A., Harris, S., McManus, R., Davenport, M. H., Sopper, M. M., & Wolfe, L. A. (2010). Nutrition and exercise prevent excess weight gain in overweight pregnant women. Medicine & Science in Sports & Exercise, 42(2), 265–272. https://doi.org/10.1249/MSS.0b013e3181b5419a
17. Mottola, M. F., Davenport, M. H., Ruchat, S.-M., Davies, G. A., Poitras, V. J., Gray, C. E., Garcia, A. J., Barrowman, N., Adamo, K. B., Duggan, M., Barakat, R., Chilibeck, P., Fleming, K., Forte, M., Korolnek, J., Nagpal, T., Slater, L. G., Stirling, D., & Zehr, L. (2018). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine, 52(21), 1339–1346. https://doi.org/10.1136/bjsports-2018-100056
18. Nascimento, S. L., Surita, F. G., & Cecatti, J. G. (2012). Physical exercise during pregnancy: A systematic review. Current Opinion in Obstetrics and Gynecology, 24(6), 387–394. https://doi.org/10.1097/GCO.0b013e328359f131
19. Niu, X., Wang, K., Li, L., & Zhang, L. (2025). Exercise therapy for gestational diabetes mellitus: From basic to clinical. Frontiers in Medicine, 12, 1716883. https://doi.org/10.3389/fmed.2025.1716883
20. Perales, M., Santos-Lozano, A., Ruiz, J. R., Lucia, A., & Barakat, R. (2016). Benefits of aerobic or resistance training during pregnancy on maternal health and perinatal outcomes: A systematic review. Early Human Development, 94, 43–48. https://doi.org/10.1016/j.earlhumdev.2016.01.004
21. Pivarnik, J. M., Chambliss, H. O., Clapp, J. F., Dugan, S. A., Hatch, M. C., Lovelady, C. A., Mottola, M. F., & Williams, M. A. (2006). Impact of physical activity during pregnancy and postpartum on chronic disease risk. Medicine & Science in Sports & Exercise, 38(5), 989–1006. https://doi.org/10.1249/01.MSS.0000218147.51025.8A
22. Satyapriya, M., Nagendra, H. R., Nagarathna, R., & Padmalatha, V. (2009). Effect of integrated yoga on stress and heart rate variability in pregnant women. International Journal of Gynecology & Obstetrics, 104(3), 218–222. https://doi.org/10.1016/j.ijgo.2008.11.013
23. Stafne, S. N., Salvesen, K. Å., Romundstad, P. R., Eggebø, T. M., Carlsen, S. M., & Mørkved, S. (2012). Regular exercise during pregnancy to prevent gestational diabetes: A randomized controlled trial. Obstetrics & Gynecology, 119(1), 29–36. https://doi.org/10.1097/AOG.0b013e3182393f86