Review article| Volume 242, P170-177, November 2019

Download started.


Effects of exercise on pregnant women’s quality of life: A systematic review



      Exercise is a promising approach to improve the health of pregnant women. However, data from studies investigating exercise and the quality of life of pregnant women are inconsistent and, to date, no systematic review on this topic has been published. The aim of this review was to comprehensively assess the effects of exercise on pregnant women’s quality of life, and to determine whether exercise positively affects quality of life in this population.

      Study design

      Literature was retrieved from electronic databases, namely PubMed, EMBASE, Web of Science and the Cochrane Library, from inception to 30 October 2018. Clinical trials published in English evaluating the effects of exercise on pregnant women’s quality of life were included. The authors assessed the risk of bias in all eligible studies using the Effective Public Health Practice Project, and used a qualitative synthesis method to identify the effects of exercise on pregnant women’s quality of life.


      Thirteen studies were included. Exercise was divided into the following four modes: aerobic exercise, resistance exercise, a combination (aerobic and resistance exercises), and yoga or physical activity. Aerobic and resistance training had a mixed effect on pregnant women’s quality of life, while the combination of aerobic and resistance exercises and yoga or physical activity resulted in significant improvements.


      This systematic review is the first to suggest that group-based combined exercise and yoga or physical activity are associated with significant benefits related to improvements in pregnant women’s quality of life. Furthermore, aerobic or resistance exercise could potentially improve pregnant women’s quality of life. Therefore, it is recommended that medical service providers should pay more attention to the importance of exercise, and develop tailored exercise programmes to promote improvements in pregnant women’s quality of life.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


        • Taylor V.R.
        Measuring healthy days; population assessment of health-related quality of life.
        Centers for Disease Control and Prevention, Atlanta, GA2015
        • Vallim A.L.
        • Osis M.J.
        • Cecatti J.G.
        • Baciuk E.P.
        • Silveira C.
        • Cavalcante S.R.
        Water exercises and quality of life during pregnancy.
        Reprod Health. 2011; 8: 14
        • Kolu P.
        • Raitanen J.
        • Luoto R.
        Physical activity and health-related quality of life during pregnancy: a secondary analysis of a cluster-randomised trial.
        Matern Child Health J. 2014; 18: 2098-2105
        • Chang S.R.
        • Chen K.H.
        • Lin M.I.
        • Lin H.H.
        • Huang L.H.
        • Lin W.A.
        A repeated measures study of changes in health-related quality of life during pregnancy and the relationship with obstetric factors.
        J Adv Nurs. 2014; 70: 2245-2256
        • Nascimento S.
        • Surita F.
        • Parpinelli M.
        • Siani S.
        • Pinto E.S.J.
        The effect of an antenatal physical exercise programme on maternal/perinatal outcomes and quality of life in overweight and obese pregnant women: a randomised clinical trial.
        BJOG. 2011; 118: 1455-1463
        • Kazemi F.
        • Nahidi F.
        • Kariman N.
        Exploring factors behind pregnant women’s quality of life in Iran: a qualitative study.
        Electron Physician. 2017; 9: 5991-6001
        • Lau Y.
        • Htun T.P.
        • Lim P.I.
        • Ho-Lim S.S.T.
        • Chi C.
        • Tsai C.
        • et al.
        Breastfeeding attitude, health-related quality of life and maternal obesity among multi-ethnic pregnant women: a multi-group structural equation approach.
        Int J Nurs Stud. 2017; 67: 71-82
        • Effati-Daryani F.
        • Mirghafourvand M.
        • Mohammad-Alizadeh-Charandabi S.
        • Shiri-Sarand F.
        • Zarei S.
        Sleep quality and its relationship with quality of life in Iranian pregnant women.
        Int J Nurs Pract. 2017; 23 (Epub 2017 Jan 25)
        • Glover V.
        Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done.
        Best Pract Res Clin Obstet Gynaecol. 2014; 28: 25-35
      1. ACOG Committee Opinion No. 650. Physical activity and exercise during pregnancy and the postpartum period.
        Obstet Gynecol. 2015; 126: e135-e142
        • Piercy K.L.
        • Troiano R.P.
        • Ballard R.M.
        • Carlson S.A.
        • Fulton J.E.
        • Galuska D.A.
        • et al
        The physical activity guidelines for Americans.
        JAMA. 2018; 320: 2020-2028
        • O’Connor P.J.
        • Poudevigne M.S.
        • Johnson K.E.
        • Brito de Araujo J.
        • Ward-Ritacco C.L.
        Effects of resistance training on fatigue-related domains of quality of life and mood during pregnancy: a randomized trial in pregnant women with increased risk of back pain.
        Psychosom Med. 2018; 80: 327-332
        • Fazzi C.
        • Saunders D.H.
        • Linton K.
        • Norman J.E.
        • Reynolds R.M.
        Sedentary behaviours during pregnancy: a systematic review.
        Int J Behav Nutr Phys Activ. 2017; 14: 32
        • Bahadoran P.
        • Mohamadirizi S.
        Relationship between physical activity and quality of life in pregnant women.
        Iran J Nurs Midwifery Res. 2015; 20: 282-286
        • Perales M.
        • Santos-Lozano A.
        • Ruiz J.R.
        • Lucia A.
        • Barakat R.
        Benefits of aerobic or resistance training during pregnancy on maternal health and perinatal outcomes: a systematic review.
        Early Hum Dev. 2016; 94: 43-48
        • Hesketh K.R.
        • Evenson K.R.
        Prevalence of U.S. Pregnant women meeting 2015 ACOG physical activity guidelines.
        Am J Prev Med. 2016; 51: e87-e89
        • Mourady D.
        • Richa S.
        • Karam R.
        • Papazian T.
        • Moussa F.H.
        • El-Osta N.
        • et al.
        Associations between quality of life, physical activity, worry, depression and insomnia: a cross-sectional designed study in healthy pregnant women.
        PLoS One. 2017; 12e0178181
        • Campolong K.
        • Jenkins S.
        • Clark M.M.
        • Borowski K.
        • Nelson N.
        • Moore K.M.
        • et al.
        The association of exercise during pregnancy with trimester-specific and postpartum quality of life and depressive symptoms in a cohort of healthy pregnant women.
        Arch Women Ment Health. 2018; 21: 215-224
        • Gong H.
        • Ni C.
        • Shen X.
        • Wu T.
        • Jiang C.
        Yoga for prenatal depression: a systematic review and meta-analysis.
        BMC Psychiatry. 2015; 15: 14
        • Du MC Ouyang Y.Q.
        • Nie X.F.
        • Huang Y.
        • Redding S.R.
        Effects of physical exercise during pregnancy on maternal and infant outcomes in overweight and obese pregnant women: a meta-analysis.
        Birth. 2018;
        • Almousa S.
        • Lamprianidou E.
        • Kitsoulis G.
        The effectiveness of stabilising exercises in pelvic girdle pain during pregnancy and after delivery: a systematic review.
        Physiother Res Int. 2018; 23
        • Gustafsson M.
        • Stafne S.
        • Romundstad P.
        • Morkved S.
        • Salvesen K.
        • Helvik A.-S.
        The effects of an exercise programme during pregnancy on health-related quality of life in pregnant women: a Norwegian randomised controlled trial.
        BJOG. 2016; 123: 1152-1160
        • Seneviratne S.N.
        • Jiang Y.
        • Derraik J.G.B.
        • McCowan L.M.E.
        • Parry G.K.
        • Biggs J.B.
        • et al.
        Effects of antenatal exercise in overweight and obese pregnant women on maternal and perinatal outcomes: a randomised controlled trial.
        BJOG. 2016; 123: 588-597
        • Haakstad L.
        • Torset B.
        • Bø K.
        What is the effect of regular group exercise on maternal psychological outcomes and common pregnancy complaints? An assessor blinded RCT.
        Midwifery. 2016; 32: 81-86
        • Moher D.
        • Liberati A.
        • Tetzlaff` J.
        • Altman D.G.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        PLoS Med. 2009; 6: e1000097
        • Saligheh M.
        • Hackett D.
        • Boyce P.
        • Cobley S.
        Can exercise or physical activity help improve postnatal depression and weight loss? A systematic review.
        Arch Women Ment Health. 2017; 20: 595-611
        • Wolin K.Y.
        • Schwartz A.L.
        • Matthews C.E.
        • Courneya K.S.
        • Schmitz K.H.
        Implementing the exercise guidelines for cancer survivors.
        J Support Oncol. 2012; 10: 171-177
        • Jackson N.
        • Waters E.
        Criteria for the systematic review of health promotion and public health interventions.
        Health Promot Int. 2005; 20: 367-374
        • Montoya Arizabaleta A.V.
        • Orozco Buitrago L.
        • Cecilia Aguilar de Plata A.
        • Mosquera Escudero M.
        • Ramirez-Velez R.
        Aerobic exercise during pregnancy improves health-related quality of life: a randomised trial.
        J Physiother. 2010; 56: 253-258
        • Rakhshani A.
        • Maharana S.
        • Raghuram N.
        • Nagendra H.
        • Venkatram P.
        Effects of integrated yoga on quality of life and interpersonal relationship of pregnant women.
        Qual Life Res. 2010; 19: 1447-1455
        • Akmese Z.
        • Oran N.
        Effects of progressive muscle relaxation exercises accompanied by music on low back pain and quality of life during pregnancy.
        J Midwifery Womens Health. 2014; 59: 503-509
        • Claesson I.-M.
        • Klein S.
        • Sydsjo G.
        • Josefsson A.
        Physical activity and psychological well-being in obese pregnant and postpartum women attending a weight-gain restriction programme.
        Midwifery. 2014; 30: 11-16
        • Petrov F.K.
        • Glantz A.
        • Fagevik O.M.
        The efficacy of moderate-to-vigorous resistance exercise during pregnancy: a randomized controlled trial.
        Acta Obstet Gynecol Scand. 2014; 94: 35-42
        • Watelain E.
        • Pinti A.
        • Doya R.
        • Garnier C.
        • Toumi H.
        • Boudet S.
        Benefits of physical activities centered on the trunk for pregnant women.
        Phys Sportsmed. 2017; 45: 293-302
        • Calou C.G.P.
        • de Oliveira M.F.
        • Carvalho F.H.C.
        • Soares P.
        • Bezerra R.A.
        • de Lima S.K.M.
        • et al.
        Maternal predictors related to quality of life in pregnant women in the Northeast of Brazil.
        Health Qual Life Outcomes. 2018; 16: 109
        • Marchetti D.
        • Carrozzino D.
        • Fraticelli F.
        • Fulcheri M.
        • Vitacolonna E.
        Quality of life in women with gestational diabetes mellitus: a systematic review.
        J Diabetes Res. 2017; 20177058082
        • Backhausen M.G.
        • Tabor A.
        • Albert H.
        • Rosthoj S.
        • Damm P.
        • Hegaard H.K.
        The effects of an unsupervised water exercise program on low back pain and sick leave among healthy pregnant women – a randomised controlled trial.
        PLoS One. 2017; 12e0182114
        • Cai H.
        • Li G.
        • Zhang P.
        • Xu D.
        • Chen L.
        Effect of exercise on the quality of life in type 2 diabetes mellitus: a systematic review.
        Qual Life Res. 2017; 26: 515-530
        • Krzepota J.
        • Sadowska D.
        • Biernat E.
        Relationships between physical activity and quality of life in pregnant women in the second and third trimester.
        Int J Environ Res Public Health. 2018; 15 (pii E2745)
        • Madsen M.
        • Jorgensen T.
        • Jensen M.L.
        • Juhl M.
        • Olsen J.
        • Andersen P.K.
        • et al.
        Leisure time physical exercise during pregnancy and the risk of miscarriage: a study within the Danish National Birth Cohort.
        BJOG. 2007; 114: 1419-1426
        • Hegaard H.K.
        • Ersboll A.S.
        • Damm P.
        Exercise in pregnancy: first trimester risks.
        Clin Obstet Gynecol. 2016; 59: 559-567
        • Gul B.
        • Riaz M.A.
        • Batool N.
        • Yasmin H.
        • Riaz M.N.
        Social support and health related quality of life among pregnant women.
        J Pak Med Assoc. 2018; 68: 872-875
        • Yeo S.
        • Cisewski J.
        • Lock E.F.
        • Marron J.S.
        Exploratory analysis of exercise adherence patterns with sedentary pregnant women.
        Nurs Res. 2010; 59: 280-287