The Impact of Outdoor Physical Activities on the Health of Pregnant Women: A Scoping Review

Background: Outdoor physical activity encompassing structured exercise, recreational activities, and environmentally facilitated movement, during pregnancy may confer benefits through both exercise and exposure to natural environments and sunlight. However, evidence on maternal health outcomes remains heterogeneous and has not been systematically mapped. This scoping review aimed to synthesize research on outdoor physical activity and nature-based environmental exposure during pregnancy, and their associations with maternal metabolic, cardiovascular, and mental health outcomes, as well as pregnancy-related outcomes. Methods: The review followed PRISMA-ScR guidelines. PubMed, Web of Science, Scopus, and Google Scholar were searched for studies published between January 2013 and February 2026. Records were screened against predefined eligibility criteria. Methodological quality was assessed with design-specific tools: PEDro for randomized controlled trials; the Newcastle–Ottawa Scale for cohort and case–control studies; and JBI and CASP checklists for cross-sectional, quasi-experimental, pilot, and qualitative studies. Results: Of 935 identified records, 22 met the eligibility criteria. Outdoor exposure was operationalized through structured outdoor programs (mainly walking-based), self-reported outdoor activity patterns, and environmental indicators such as residential greenness and neighborhood walkability. Outcomes clustered into metabolic and cardiometabolic measures, mental health indicators, pregnancy and birth outcomes, and behavioral or environmental determinants of physical activity. Overall, most studies (17 of 22) reported at least one positive association, with the most consistent evidence for metabolic outcomes and mental health, whereas pregnancy and birth outcomes yielded more heterogeneous results. Conclusions: Outdoor physical activity and supportive natural or built environments may be associated with favorable maternal metabolic and mental health during pregnancy. Nevertheless, heterogeneity in exposure assessment and study design limits comparability and constrains causal inference. Future research should standardize outdoor exposure metrics and apply designs capable of isolating environmental effects from exercise alone.