Impact of physical activity on maternal and neonatal outcomes among women with vaginal births-single center prospective cohort study

Abstract

Background: Optimal levels of physical activity during pregnancy are associated with numerous health benefits for both the mother and fetus. Additionally, maternal exercise has been linked to improved cardiovascular fitness, reduced lower back pain, enhanced mental wellbeing and favorable neonatal outcomes, including a lower risk of macrosomia and improved placental function. However, both insufficient and excessive physical activity levels may have adverse effects, highlighting the need for a balanced approach.

Objective: The aim of this study was to evaluate the impact of physical activity before and during pregnancy on maternal perinatal outcomes and neonatal condition. The hypothesis proposes that physical activity at the level recommended by the World Health Organization (WHO) does not negatively affect maternal or neonatal outcomes.

Methods: This single-center prospective cohort study was conducted at a tertiary care hospital in northern Poland. Participants were recruited from antenatal outpatient clinics and classified based on their physical activity levels before and during pregnancy according to WHO as well as Canadian and the American College of Obstetricians and Gynecologists' guidelines. Data collection occurred in two stages: first, through a questionnaire including socio-demographic data and the Polish version of the Get Active Questionnaire for Pregnancy, and second, by analyzing biomedical data routinely collected during childbirth. A total of 115 cases were included in the final analysis. Statistical analyses comprised logistic and linear regression model implementation, as well as the Student's t-test, Welch's t-test and the Mann-Whitney U-test, with the level of statistical significance set at p < 0.001.

Results: No statistically significant effects of physical activity before or during pregnancy were observed on platelet count, hemoglobin levels, C-reactive protein concentrations, labor duration, BMI changes, anesthesia use, perineal trauma, or neonatal outcomes (including birth mass, length, head circumference, chest circumference, APGAR scores, and umbilical cord blood parameters).

Conclusion: Physical activity before and during pregnancy does not negatively impact maternal or neonatal outcomes. These findings support current physical activity recommendations during pregnancy, emphasizing the need for further research on the mechanisms underlying hematological changes associated with exercise.

Keywords: health behavior; infant health; maternal health; physical activity; pregnancy.