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Review
. 2024 Jul 19:15:1370079.
doi: 10.3389/fphys.2024.1370079. eCollection 2024.

Maternal posture-physiology interactions in human pregnancy: a narrative review

Allan J Kember  1   2 , Jennifer L Anderson  3 , Natalyn E Gorazd  4 , Sarah C House  5 , Katherine E Kerr  4 , Paula A Torres Loza  4 , David G Reuter  6 , Sebastian R Hobson #  1   7   8 , Craig J Goergen #  4
Affiliations
Review

Maternal posture-physiology interactions in human pregnancy: a narrative review

Allan J Kember et al. Front Physiol. .

Abstract

There are several well-known medical conditions in which posture and gravity interact with natural history, including pregnancy. In this review, we provide a comprehensive overview of interactions between maternal posture and maternal physiology and pathophysiology at rest during pregnancy. We conducted a systematic literature search of the MEDLINE database and identified 644 studies from 1991 through 2021, inclusive, that met our inclusion criteria. We present a narrative review of the resulting literature and highlight discrepancies, research gaps, and potential clinical implications. We organize the results by organ system and, commencing with the neurological system, proceed in our synthesis generally in the craniocaudal direction, concluding with the skin. The circulatory system warranted our greatest and closest consideration-literature concerning the dynamic interplay between physiology (heart rate, stroke volume, cardiac output, blood pressure, and systemic vascular resistance), pathophysiology (e.g., hypertension in pregnancy), and postural changes provide an intricate and fascinating example of the importance of the subject of this review. Other organ systems discussed include respiratory, renal, genitourinary, gastrointestinal, abdominal, and endocrine. In addition to summarizing the existing literature on maternal posture-physiology interactions, we also point out gaps and opportunities for further research and clinical developments in this area. Overall, our review provides both insight into and relevance of maternal posture-physiology interactions vis à vis healthcare's mission to improve health and wellness during pregnancy and beyond.

Keywords: gravity; maternal; obstetrics; pathophysiology; physiology; posture; pregnancy.

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Conflict of interest statement

Author AK was employed by Shiphrah Biomedical Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram outlining the study selection process.
FIGURE 2
FIGURE 2
Changes in systolic blood pressure (upper line), diastolic blood pressure (lower line), and heart rate (dashed line) in one subject as an example of experimental design. Note that while the stick figure appears supine in the figure above, the participant actually started out in the left lateral recumbent posture, then changed to the standing posture, then returned to the left lateral decubitus posture. Used with permission from Springer Nature (Hohmann and Künzel, 1991)
FIGURE 3
FIGURE 3
Illustration of the abdominopelvic region in the third trimester of pregnancy reveals the anterior-posterior orientation of the right common iliac artery crossing over the left common iliac vein, compressing it close to where it enters the inferior vena cava. The uterus and fetus are seen overlying the aortocaval bifurcation. Also shown are the left common iliac artery and the right common iliac vein. Figure created with Biorender.com.
FIGURE 4
FIGURE 4
Summary diagram of maternal posture-physiology interactions during pregnancy grouped by organ system (bold text). Physiologic variables affected by maternal posture are in plain text, while pathophysiology is in italic text. Figure created with BioRender.com.
See this image and copyright information in PMC

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    Kember AJ, Gilad N, Coleman J, Warland J, Hobson SR. Kember AJ, et al. J Clin Sleep Med. 2025 Jul 1;21(7):1319-1320. doi: 10.5664/jcsm.11616. J Clin Sleep Med. 2025. PMID: 40110630 Free PMC article. No abstract available.

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