Exercise during pregnancy (frequency, intensity, type, time, volume): birth outcomes in women at risk of hypertensive disorders of pregnancy

doi:10.1016/j.xagr.2025.100472

AJOG Global Reports

Volume 5, Issue 2, May 2025, 100472

https://doi.org/10.1016/j.xagr.2025.100472 Get rights and content

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Open access

Highlights

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Why was this study conducted? While the beneficial influence of prenatal exercise on reducing the risk of gestational conditions has been shown, information is lacking on proper dosing of exercise training regimens in women at risk of hypertensive disorders of pregnancy (HDP).
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What are the key findings? Higher exercise volume led to lower systolic blood pressure during pregnancy, normalized gestational length, and increased offspring birthweight. Further, weekly exercise duration predicted birthweight independent of gestational length.
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What does this study add to what is already known? Evidence has shown that exercise has a beneficial influence on HDP at-risk pregnancies. The current findings further show a volume-dependent effect of prenatal exercise on improving birth outcomes in at-risk pregnancies. These findings highlight the importance of meeting recommended levels of exercise in women at risk of HDP.

Abstract

Background

Hypertensive disorders of pregnancy (HDP) hold negative health implications for mothers and offspring. While the beneficial influence of prenatal exercise on reducing HDP risk has been previously shown, there is a lack of specific information on the effect on birth outcomes in at-risk women, and in-depth analysis of appropriate exercise dose is lacking.

Objective

We aimed to elucidate the effects of exercise training FITT-V (frequency, intensity, type, time, volume) on hypertension and birth outcomes in pregnant women.

Study Design

This study is a retrospective, secondary analysis of pooled data from three blinded, prospective, randomized controlled trials. Women at risk of HDP (11 control, 27 exercise) were identified from the population and monitored in supervised exercise sessions throughout pregnancy. Upon delivery, birth measures were obtained. Pearson correlations and stepwise regressions determined associations. Tests for outcomes between exercise types were completed using one-way ANOVA.

Results

Women at risk of HDP with higher total exercise volume trended lower systolic blood pressure during pregnancy (P=.07). In at-risk women, total and weekly exercise volume were then associated with gestational age at birth (R=0.42, P=.03; R=0.46, P=.02) and increased birthweight (R=0.43, P=.03). Weekly exercise duration predicted birthweight (P=.02) independent of gestational age at birth.

Conclusion

The current findings add to a body of literature showing the beneficial influence of exercise during pregnancy on HDP risk, and importantly the effect on exposed offspring. Prenatal exercise improved birth outcomes in women with higher HDP risk in a dose-dependent manner, whereby higher exercise volume and duration are associated with improvements in birth outcomes.

Key words

birth measures

dose-response

exercise

FITT-V

hypertensive disorders of pregnancy

pregnancy

Cited by (0)

: Funding: This research was supported by American Heart Association Grant #15GRNT24470029 (PI Linda May) #18IPA3410006 (PI Linda May) and internal grant from East Carolina University.

: Ethics Approval: This study used data from participants enrolled in a randomized control trial (ClinicalTrials.gov Identifier: NCT03517293). Approval for this study was obtained from the East Carolina University Institutional Review Board. All experimental procedures were conducted at East Carolina University.

: Data Transparency: Data will be made available upon request.

: Condensation: In women at risk of developing hypertension during pregnancy, higher exercise volume led to lower blood pressure during pregnancy, while also increasing gestational age at birth and increasing birthweight in their offspring.

: Conflicts of Interest: The authors report no conflict of interest.