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Published on: April 5, 2024
Comparative effect of different types of physical exercise and intensity levels on low birth weight: A systematic
Valentina Díaz-Goñi1, Iván Cavero-Redondo2,3, Bruno Bizzozero-Peroni1,4
1Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain.
Insights
Moderate-to-vigorous strength exercises during pregnancy may help prevent low birth weight (LBW) in healthy populations. However, evidence quality is low, requiring cautious interpretation of these physical exercise findings.
Area of Science:
- Obstetrics and Gynecology
- Sports Medicine
- Public Health
Background:
- Low birth weight (LBW) is a significant contributor to neonatal mortality and morbidity.
- Current evidence lacks clarity on the effectiveness of specific physical exercise types and intensities during pregnancy for LBW prevention.
Purpose of the Study:
- To compare the efficacy of various physical exercise modalities and intensities in pregnant women for preventing low birth weight.
Main Methods:
- A systematic review and network meta-analysis of randomized controlled trials (RCTs) were conducted.
- Searches included major databases (PubMed, Cochrane, Scopus, Web of Science) up to November 2023.
- Network meta-analysis used a random effects model and frequentist approach.
Main Results:
- Thirty-eight RCTs informed the network meta-analysis.
- Moderate-to-vigorous strength exercise showed a significant effect in preventing LBW in healthy pregnant women (MD: 310.00, 95% CI: 78.40–541.60).
- Light-to-moderate strength and moderate-to-vigorous Pilates exercises showed favorable but non-significant trends.
Conclusions:
- Moderate-to-vigorous intensity strength exercises may be a viable strategy for preventing LBW in healthy pregnant individuals.
- Findings should be interpreted cautiously due to overall low certainty of evidence and risk of bias concerns.
Background:
Low birth weight (LBW) has been established as a major determinant of neonatal mortality and morbidity. However, there is no evidence of the effectiveness of different types of physical exercise (PE) at different intensities during pregnancy to prevent LBW.
Objectives:
To compare the effectiveness of different types of PE at different levels of intensity in pregnant women to prevent LBW.
Design:
A systematic review and network meta-analysis was performed according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols for Network Meta-Analysis extension statement.
Data Sources And Methods:
We searched the PubMed, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases from inception to November 2023. We included randomized controlled trials (RCTs). A random effects method was used to calculate the pooled mean difference (MD). The effect of each intervention was calculated using a network meta-analysis with a frequentist perspective.
Results:
Forty-three RCTs were included in the systematic review, and 38 RCTs were included in the network meta-analysis. In the general population, although no significant results, the MDs for light-moderate strength, moderate-vigorous strength, and moderate-vigorous Pilates exercises were favorable for preventing LBW. Furthermore, moderate-vigorous strength exercise was effective to prevent LBW, reporting significant MD compared to control groups in the healthy population (310.00, 95% confidence interval: 78.40, 541.60; I2 = 81.3%).
Conclusion:
Strength exercises at a moderate-vigorous intensity could be a potential strategy for the prevention of LBW in the healthy population. However, our findings should be interpreted with caution because the overall risk of bias was between "some concerns" and "high," and the overall certainty of the evidence was low.
Registration:
PROSPERO CRD42023401770.
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