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Influence of Prenatal Exercise on Apgar Score and Health-Related Physical Fitness in Childhood: A Systematic Review
Sandra Sánchez-Parente1,2, Ángela Rodríguez-Perea3,4, Sandra Solaguren-Beaskoa5
1GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, Puerto Real, Spain, uca.es.
Introduction:
Adequate health-related physical fitness (HRPF) in early years is essential for an optimal future quality of life. Consequently, exploring whether prenatal exercise can improve it in the descendants is of undoubted public health interest.
Purpose:
The aim of this study is to analyze the influence of prenatal exercise on Apgar score and childhood HRPF and to identify possible differences based on maternal age and pre-pregnancy body mass index.
Materials And Methods:
The search was conducted on PubMed and Web of Science databases. Through PRISMA flow diagram, studies that met the inclusion criteria were selected. Risk of bias and quality of evidence were conducted using Cochrane and GRADE, respectively. We performed a meta-analysis using Review Manager, JASP, and Jamovi. Heterogeneity was assessed by the Cochran-Q statistic, and effect size was conducted with a random-effects model. Sensitivity analysis was performed through casewise diagnostic analysis, and publication bias was evaluated through visual inspection of funnel plots and Egger's regression test.
Results:
Sixty-nine studies were included in the systematic review and 52 in the meta-analysis. Apgar score at 1 min was higher in neonates whose mothers performed overall, resistance, and concurrent exercise during gestation (p = 0.001; p = 0.04; p = 0.03, respectively). Overall exercise during pregnancy was associated with better Apgar score at 5 min (p = 0.04). Overall and aerobic exercise during pregnancy reduced body birth weight within normal ranges (p = 0.02; p = 0.009). No significant differences between groups were found in other outcomes.
Conclusion:
Exercise during pregnancy improves Apgar score at 1 and 5 min and reduces body birth weight within normal values. Further follow-up studies assessing the influence of exercise interventions on children's HRPF are needed.