Pregnant and postpartum women gait kinematics parameters: A systematic review and meta-analysis

During pregnancy, adaptive gait mechanisms are hypothesized to develop to accommodate physiological changes from fetal growth.

What are the average values and variations of gait kinematic and spatiotemporal parameters in pregnant and postpartum women?

A bibliographic search was conducted in Scopus, PubMed, Web of Science, and Embase up to February 3rd, 2025. Observational studies and randomized controlled trials assessing gait kinematic or spatiotemporal parameters in pregnant and postpartum women were included. Risk of bias was assessed using JBI Critical Appraisal Tools. Standardized mean difference and confidence intervals compared pregnancy, postpartum, and control groups. The I² index assessed study heterogeneity; a random-effects model was used if I² exceeded 40 %.

Thirty-two studies were included. Meta-analyses were performed for sagittal and transverse pelvic ROM, gait speed, cadence, stride length, double support time, step length, and step width. No significant differences were found in sagittal and transverse pelvic ROM between the second and third trimesters. Pregnant women walked more slowly than postpartum and non-pregnant women, but no significant differences in gait speed, cadence, stride length, step length, double support time, or step width were found between trimesters. Findings from non-pooled studies indicated increased pelvic tilt, knee flexion, and lateral foot progression angle, with decreased hip extension and ankle plantarflexion. Pregnant women walked with reduced step length, swing phase, and single support time, alongside increased double support duration. These changes were most prominent in the 3rd trimester, some appearing in the 2nd trimester, and tended to lessen postpartum, though spatiotemporal disparities remained compared to non-pregnant women. The persistence of kinematic differences remains uncertain.

This study enhances understanding of biomechanical gait adaptations during pregnancy and postpartum, providing a foundation for more effective, patient-centered care.