Effects of prenatal exercise on incidence of congenital anomalies and hyperthermia: a systematic review and meta-analysis.

Margie H Davenport, Courtney Yoo, Michelle F Mottola, Veronica J Poitras, Alejandra Jaramillo Garcia, Casey E Gray, Nick Barrowman, Gregory A Davies, Amariah Kathol, Rachel J Skow, Victoria L Meah, Laurel Riske, Frances Sobierajski, Marina James, Taniya S Nagpal, Andree-Anne Marchand, Linda G Slater, Kristi B Adamo, Ruben Barakat, Stephanie-May Ruchat

Journal: British journal of sports medicine 2019;53(2):116-123

PMID: 30337347

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Abstract

OBJECTIVE

To investigate the relationships between exercise and incidence of congenital anomalies and hyperthermia.

DESIGN

Systematic review with random-effects meta-analysis .

DATA SOURCES

Online databases were searched from inception up to 6 January 2017.

STUDY ELIGIBILITY CRITERIA

Studies of all designs were eligible (except case studies and reviews) if they were published in English, Spanish or French, and contained information on population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone ["exercise-only"] or in combination with other intervention components [e.g., dietary; "exercise + co-intervention"]), comparator (no exercise or different frequency, intensity, duration, volume or type of exercise) and outcome (maternal temperature and fetal anomalies).

RESULTS

This systematic review and meta-analysis included 'very low' quality evidence from 14 studies (n=78 735) reporting on prenatal exercise and the odds of congenital anomalies, and 'very low' to 'low' quality evidence from 15 studies (n=447) reporting on maternal temperature response to prenatal exercise. Prenatal exercise did not increase the odds of congenital anomalies (OR 1.23, 95% CI 0.77 to 1.95, I=0%). A small but significant increase in maternal temperature was observed from pre-exercise to both during and immediately after exercise (during: 0.26°C, 95% CI 0.12 to 0.40, I=70%; following: 0.24°C, 95% CI 0.17 to 0.31, I=47%).

SUMMARY/CONCLUSIONS

These data suggest that moderate-to-vigorous prenatal exercise does not induce hyperthermia or increase the odds of congenital anomalies. However, exercise responses were investigated in most studies after 12 weeks' gestation when the risk of de novo congenital anomalies is negligible.

Address: Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.; R Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine & Dentistry, Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada.; Independent Researcher, Ottawa, Ontario, Canada.; Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.; Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.; Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada.; Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK.; Department of Anatomy, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada.; John W Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada.; Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.; Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain.; Department of Human Kinetics, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada.

DOI: 10.1136/bjsports-2018-099653

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MeSH Terms: Body Temperature, Congenital Abnormalities, Exercise, Female, Fever, Humans, Pregnancy, Randomized Controlled Trials as Topic