Association between regular physical activity during pregnancy and perinatal outcomes: A population-based cohort study

Abstract

Introduction

Regular physical activity during pregnancy is associated with several maternal and neonatal health benefits. However, most studies focus on specific forms of exercise in low-risk populations, limiting generalizability.

Objective

To investigate associations between regular physical activity during singleton pregnancy and perinatal outcomes using a national perinatal registry.

Methods

A population-based cohort study was conducted using data from the Slovenian National Perinatal Information System (2013–2022), which included 190,331 singleton pregnancies. Regular physical activity was defined as any form of physical activity at least twice weekly throughout pregnancy. The outcomes analyzed included preterm birth (<37 and <32 weeks), preeclampsia, gestational hypertension, gestational diabetes mellitus (GDM), pelvic girdle pain, small-for-gestational-age (SGA) and large-for-gestational-age (LGA) neonates, cesarean delivery, urinary incontinence postpartum, and Apgar scores < 7 at 5 minutes. Multivariate logistic regression adjusted for parity, maternal age, BMI, prepregnancy hypertension and diabetes, and gestational weight gain.

Results

Regular physical activity during pregnancy was reported by 69 % of the women. It was significantly associated with reduced odds of preterm birth (<37 weeks, aOR 0.658; <32 weeks, aOR 0.393), preeclampsia (aOR 0.719), gestational hypertension (aOR 0.708), pelvic girdle pain (aOR 0.808), SGA (aOR 0.903), LGA (aOR 0.902) and low Apgar scores (aOR 0.638). Physically active women with GDM were less likely to require insulin (aOR 0.768). No significant associations were found with cesarean delivery or urinary incontinence.

Conclusion

Regular physical activity during pregnancy, regardless of specific type, was associated with improved perinatal outcomes without safety concerns. These findings highlight the potential benefits of encouraging physical activity during pregnancy in diverse populations.