Physical activity during pregnancy and gestational weight gain depending on pre-pregnancy body mass index: systematic review and meta-analysis

Maternal weight gain during pregnancy is one of the most important outcomes that healthcare professionals have, as excessive weight gain is associated with maternal, foetal, and newborn complications. However, the prevalence of excessive weight gain continues to increase worldwide. The benefits that physical activity could have during pregnancy have been demonstrated in several areas, including adequate control of weight gain, therefore, the objective of this meta-analysis was to examine the impact of physical activity during pregnancy on gestational weight gain. Systematic review and meta-analysis (Registration No.: CRD42022374014). Articles written in English and Spanish published between January 2010 and May 2024 were searched. This study exclusively included randomised controlled trials involving pregnant women and interventions consisting of physical activity during pregnancy. The primary outcome was gestational weight gain, and other outcomes were excessive weight gain and gestational weight gain depending on body mass index during pregnancy. Fifty-four studies were included in this review. The intervention groups were compared with the control groups. Pregnant women in intervention groups experienced a significant reduction in gestational weight gain compared to control group (z = 4.73, p < 0.001), with greater effects in terms of mean differences to gain less gestational weight gain in supervised physical activity interventions and comprising various types of physical activity in the intervention programme, despite the absence of significant differences in the test for subgroup differences (p > 0.05). Furthermore, the appearance of excessive gestational weight gain resulted in a large reduction in intervention group (z = 6.09, p < 0.001). Analyses based on body mass index before pregnancy revealed that women with normal weight in intervention group experienced lower gestational weight gain (z = 3.58, p < 0.01). Physical activity during pregnancy can help better control an adequate gestational weight gain, in women of normal weight, reduce the risk of excessive weight gain, and with a trend to better manage the weight gain after a supervised intervention or involving more than one type of physical activity.