Effects of pilates training on vaginal delivery outcomes: a systematic review and meta-analysis

Labor pain and prolonged labor duration influence maternal well-being and birth experiences. Prenatal exercise has been widely recognized as a beneficial intervention to support maternal health and labor outcomes. Pilates, which focuses on improving core strength, flexibility, and body awareness, may contribute to reducing pain intensity and labor duration during vaginal delivery. This systematic review and meta-analysis aimed to evaluate the effects of Pilates training on labor pain and the duration of labor. A comprehensive search was conducted by the PRISMA (Preferred Reporting Item for Systematic Reviews-Meta-Analysis) guidelines across PubMed, ScienceDirect, and Scopus up to January 2, 2024, including randomized controlled trials and cohort studies published between 2001 and 2023 in English or Indonesian. The primary outcome was labor pain measured using the Visual Analogue Scale (VAS), and the secondary outcome was total labor duration. A total of five studies involving 409 participants met the inclusion criteria. The pooled analysis of three studies showed that Pilates significantly reduced labor pain (Mean Difference:1.13, 95 % CI:1.64 to - 0.61), though moderate heterogeneity was observed (I² = 68 %). Regarding labor duration, Pilates was associated with a substantial reduction (Mean Difference:97.84 min, 95 % CI:136.70 to -58.98) with negligible heterogeneity (I² = 0 %). However, moderate heterogeneity in pain reduction outcomes (I² = 68 %) suggests study variability, indicating a need for further research.