Correlates of physical activity during pregnancy: A systematic review

Abstract Background Physical activity among pregnant women is an important public health measure because it improves the health of mother and child due to a reduced risk of pregnancy complications and chronic diseases. Thus, the main objective was to perform a comprehensive, unrestricted and systematic literature review including different correlates of physical activity (PA) in pregnancy. The secondary objective was to execute a quality assessment and evaluate the consistency across study populations, study designs, settings, year of publication, and countries. Methods A thorough and systematic literature search of the databases MEDLINE ALL (Ovid) and Embase (Ovid) up until January 19, 2023, was executed by a professional librarian. We did not restrict our search regarding language, time of publication or health status of participants. Two authors (SMA and KMO) independently performed screening and extraction of data, before agreeing on final consensus. The review is reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement (Registration number in PROSPERO: 473006). Results Of 7,894 records identified in the literature search, we reviewed 29 original articles, out of which 17 were cohort studies. Study sizes varied from 134 to 88,200 individuals from 14 different countries. Most studies included healthy singleton pregnant women from high income countries. Overall, we observed low consistency for the different correlates and the quality of evidence ranged from very low to moderate. Maternal education and pre-pregnancy body mass index were among the most reported and were the two most consistent correlates of PA based on moderate quality of evidence. Few studies included environmental correlates. Conclusions The existing studies on correlates of physical activity in pregnancy are of very low to moderate quality. A wide range of correlates have been studied but we observed low consistency. Key messages • We need more studies on correlates of physical activity in pregnant women from low- and middle-income countries. • Upcoming studies must ensure high quality when studying correlates of physical activity in pregnancy.