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The effects of different types of prenatal exercise on neonatal outcomes: a systematic review and network
Cuiyue Kong1, Sichen Zhou1, Xianyang Xin1
1Innovation Center for Integration of Sports and Medicine, Capital University of Physical Education and Sports, Beijing, China.
Insights
Mind-body exercise (MBE) shows benefits for neonatal Apgar scores and potentially birth weight. However, evidence for improving gestational age remains insufficient across various prenatal exercise types.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Exercise Science
Background:
- Prenatal exercise is encouraged for maternal and fetal well-being.
- Different exercise modalities may yield varied neonatal outcomes.
- Systematic evaluation is needed to compare these effects.
Purpose of the Study:
- To systematically compare the effects of different prenatal exercise types on neonatal outcomes.
- To rank interventions for birth weight, gestational age, and Apgar scores.
- To synthesize evidence using network meta-analysis.
Main Methods:
- Searched major databases (PubMed, Embase, etc.) up to January 2026.
- Classified interventions into aerobic (AE), resistance (RE), mind-body (MBE), and combined exercise (CE).
- Conducted a network meta-analysis (NMA) on 61 studies (11,036 participants).
Main Results:
- Mind-body exercise (MBE) improved 1-minute and 5-minute Apgar scores compared to no intervention.
- MBE showed higher birth weight than combined exercise (CE).
- No significant differences in gestational age were found; MBE ranked highest for all outcomes, with moderate to low evidence confidence.
Conclusions:
- Prenatal exercise effects on neonatal outcomes vary by type.
- Mind-body exercise demonstrates advantages for Apgar scores and potential for birth weight.
- Further research is needed to confirm effects on gestational age due to limited evidence.
Objective:
This study aimed to systematically evaluate and compare the effects of different types of prenatal exercise on neonatal outcomes, and to assess their relative effects and rankings for birth weight, gestational age, 1-minute Apgar score, and 5-minute Apgar score.
Methods:
We searched PubMed, the Cochrane Library, Embase, Scopus, and Web of Science for studies examining the effects of prenatal exercise on pregnancy and neonatal outcomes, from database inception to January 2026. According to exercise type, the interventions were classified into aerobic exercise (AE), resistance exercise (RE), mind-body exercise (MBE, referring to exercise modalities such as yoga and Pilates that emphasize breathing regulation, postural control, and mind-body coordination), and combined exercise (CE, referring to interventions composed of two or more exercise components, such as combined aerobic and resistance exercise). A network meta-analysis (NMA) was performed to synthesize the evidence.
Results:
A total of 61 studies involving 11,036 pregnant women were ultimately included. For the 1-minute Apgar score, mind-body exercise was associated with a higher score compared with no intervention (MD = 0.33, 95% CI: 0.18 to 0.47). In the network comparison, mind-body exercise showed a higher 1-minute Apgar score than combined exercise (MD = 0.24, 95% CI: 0.06 to 0.42). For the 5-minute Apgar score, a statistically significant increase was observed only for mind-body exercise compared with no intervention (MD = 0.18, 95% CI: 0.04 to 0.32). Regarding birth weight, mind-body exercise was associated with a higher birth weight than combined exercise (MD = 104.41, 95% CI: 1.28 to 207.54). For gestational age, no statistically significant differences were observed between any intervention and no intervention or among different interventions. The cumulative ranking probability plots showed that mind-body exercise had the highest probability of ranking first across all four outcomes. The CINeMA assessment indicated that the confidence in the evidence for this network meta-analysis was mainly moderate to low.
Conclusion:
The effects of different types of prenatal exercise on neonatal outcomes were not consistent. Mind-body exercise showed a relative advantage in improving Apgar scores and may have a potential effect on birth weight; however, there is insufficient evidence to indicate that it can significantly improve gestational age.
Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/CRD420251241770, identifier CRD420251241770.
