Examining the Impact of Preconception Physical Activity on Offspring Outcomes Linked to Obesity

Obesity in childhood remains a critical public health issue, with emerging evidence highlighting developmental origins rooted in parental behaviours before conception. While diet and weight status of birthing parents are well-established predictors of offspring health, the role of preconception physical activity (PA) remains understudied. This scoping review synthesizes current evidence between preconception PA and its association with adverse birth outcomes, and downstream infant and child obesity outcomes, contextualizing findings within the broader parental lifestyle influence. A systematic literature search across ten databases identified 41 relevant studies, predominantly cohort designs, analyzing PA effects on birth weight, gestational diabetes mellitus (GDM), excessive gestational weight gain (eGWG), and offspring adiposity.

Findings revealed no consistent association between preconception PA and birth weight or preterm birth risk. However, studies suggest that preconception PA may lower the likelihood of GDM and eGWG, both of which are linked to increased obesity risk in offspring. A significant methodological limitation across studies was the widespread temporal discontinuity, with PA predominantly assessed through retrospective recall rather than objective measures. Additionally, inconsistencies in study design, PA intensity definitions, and confounding lifestyle factors limit definitive conclusions.  While obesity in birthing parents and suboptimal feeding practices dominate current etiological models, the potential preventive role of preconception PA warrants further investigation. Future research should implement intervention designs incorporating objective PA measures (e.g., accelerometry, wearable sensors) within life-course frameworks. Methodologically rigorous studies are critical for disentangling PA-specific effects from confounding lifestyle factors to inform evidence-based guidelines for preconception care.