Table 1 Characteristics of included studies
Author & Year | Country | Study design | N | Age | BMI | Gestation | Pregnancy type | Other risk factors | Intervention detail (brief description, comparison) | Type of PA measure | PA outcome measure |
|---|---|---|---|---|---|---|---|---|---|---|---|
Callaway et al 2010 [48] | Australia | Pilot RCT | 50 | Aged 18–45 | BMI ≥ 30 | Not specified | Not specified | Not specified | Intervention group: individualized exercise program with an energy expenditure EE goal of 900 kcal/ week Comparison: routine obstetric care | Self-report | Pregnancy Physical Activity Questionnaire (PPAQ) - MET (hr/week) |
Oostdam et al 2012 [54] | Amsterdam | RCT | 101 | Not specified | BMI ≥ 25 or ≥ 30 | Not specified | Not specified | At least one: macrosomia, history of GDM or relative with T2D | Exercise programme consisting of aerobic + strength exercises aimed top control blood glucose levels. Comparison: received normal care from obstetricians and or midwives | Objective | ActiTrainer accelerometer ActiGraph accelerometer - Total minutes per week of PA + MET cut -off values |
Nascimento et al 2011 [53] | Brazil | RCT | 82 | Not specified | BMI 26–29 | 14–24 weeks | Not specified | Not specified | Two components: The exercise protocol consisting of light-intensity to moderate-intensity exercises + home exercise counselling. Comparison: no physical activity counselling, received routine prenatal care | Self-report | Women recorded the type + minutes of exercise in an exercise journal |
Kong et al 2014 [50] | USA | Pilot RCT | 37 | Aged 18–45 | BMI > 25 or > 30 | Not specified | Singleton | Non-smoker, no prior history of chronic disease | Unsupervised walking program - Walking (150 min/week of moderate PA during pregnancy). Comparison: no physical activity recommendations, no restrictions from physical activity participation | Objective | StepWatch Activity Monitor (SAM) accelerometer - using step data (counts) |
Seneviratne et al 2016 [64] | Auckland New Zealand | Two arm parallel RCT | 75 | Aged 18–40 | BMI ≥ 25 | < 20 weeks | Singleton | Not specified | Structured home-based exercise programme using magnetic stationary bicycles. Comparison: no intervention or heart rate monitor | Objective | Heart rate monitor - duration and intensity of cycling |
Ong et al 2009 [56] | Western Australia | RCT | 12 | Aged 30 (±4 years) | BMI ≥ 30 | Not specified | Singleton | Sedentary women, a normal 18 week scan | Home-based supervised exercise using an upright stationary cycle ergometer that each participant kept in their home during the intervention. Comparison: continued with their usual daily activities while receiving regular antenatal care | Objective and self-report | Aerobic Power Index sub maximum test and Pregnancy PA questionnaire |
Santos et al 2005 [57] | Brazil | RCT | 72 | Aged ≥ 20 | BMI ≥ 25 | Not specified | Not specified | Non-smoking | Supervised PA consisting of warm up, heart rate monitored activity, upper and lower limbs, stretching and relaxation. Comparison: participated in once weekly sessions that included relaxation (respiratory exercises and light stretching (no aerobic or weight resistance) Participates were neither encouraged nor discouraged to exercise | Objective and self-report | Physical activity questionnaire) and the Aerobic Power Index sub maximum test- Vo2max |
Garnaes et al 2016 [65] | Norway | Single centre, parallel group RCT | 91 | Aged ≥ 18 | BMI ≥ 28 | < 18 weeks | Singleton | Live fetus at 11–14 week ultrasound scan | Supervised exercise consisting of treadmill walking/jogging for 35 min (endurance) and resistance training for large muscle groups and the pelvic floor muscles. Comparison: ordinary maternity care by their midwife, GP and or obstetrician | Self-report | PA questionnaire - Frequency, duration and intensity of weekly PA |
Dodd et al 2014 [60] | South Australia | Multicentre RCT | 1924 | Not specified | BMI ≥ 25 | Between 10 and 20 weeks | Singleton | Not specified | Lifestyle Advice consisted of dietary + lifestyle intervention including dietary, PA and behavioural strategies + goal setting. Comparison: continued pregnancy care according to local hospital guidelines | Self-report | Health-enhancing PA (SQUASH) - MET (min/week) |
Guelinckx et al 2009 [51] | Belgium | RCT | 122 | Not specified | BMI > 29 | < 15 weeks | Not specified | White | Passive group: brochure consisting of diet and PA advice + tips to limit weight gain. Active group: received the same brochure and was actively counselled. Techniques of behavioural modification were used. Comparison: routine perinatal care | Self-report | Baecke questionnaire - Total score for PA from a minimum of 3 to a maximum of 15 |
Hawkins et al 2015 [49] | Western Massachusetts | Pilot RCT | 68 | Aged 18–40 | BMI ≥ 25 | < 18 weeks | Not specified | Hispanic women, participating in < 30 min PA per week | Achieve PA guidelines through increasing walking and developing a more active lifestyle. Dietary component: decrease foods high in saturated fat and increase fibre. Comparison: standard care | Self-report | Pregnancy PA Questionnaire (PPAQ) - average MET (h/week) |
aKoivusalo et al 2016 [52] | Finland | RCT | 269 | Aged ≥ 18 | BMI ≥ 30 | < 20 weeks | Not specified | History of GDM | Dietary and PA counselling (minimum of 30 min of moderate intensity exercise and to adopt an overall active lifestyle). Comparison: received general antenatal care, information leaflets provided by the local antenatal clinics. | Self-report | Food frequency and PA questionnaire - Self report time spent weekly on PA |
Poston et al 2015 [61] | UK | Multicentre RCT | 1555 | Aged > 16 | BMI ≥ 30 | Between 15 and 18 weeks (+ 6 days) | Singleton | Not specified | SMART goals, advice on self-monitoring, problem solving. Handbook about the intervention, theory and recommended food and PA. DVD of an exercise regimen. Comparison: routine antenatal appointments at their trial centre in accordance with local practice | Self-report | PA questionnaire (IPAQ) - MET (min/week) |
Renault et al 2014 [62] | Copenhagen | Prospective RCT | 389 | Aged > 18 | BMI ≥ 30 | Between 11 and 14 weeks | Singleton | Read and speak Danish | Two intervention groups: (PA plus D and PA only) individually advised and encouraged to increase PA aiming at a daily step count of 11,000 steps. The diet intervention consisted of contact with an experienced dietician. Comparison: received usual hospital standard regimen for obese pregnant women | Objective | Pedometer - Daily steps were registered on 7 consecutive days every 4 weeks |
Szmeja et al 2014 [66] | South Australia | Nested RCT | 1108 | Not specified | BMI ≥ 25 | Between 10 and 20 weeks | Singleton | Not specified | Lifestyle advice group from (LIMIT) receive DVD or standard materials. Set goals. Received pregnancy book with nutrition + exercise in pregnancy book. Comparison: received the standard written materials and consultations | Self-report | Metabolic equivalent task units - MET (min/week) |
aVinter et al 2011 [55] | Denmark | RCT | 304 | Aged 18–40 | BMI 30–45 | Not specified | Not specified | Not specified | Two components: dietary counselling and PA. The aim was to limit GWG to 5 kg. Energy requirement was estimated and PA (30–60) min daily. Women also had free full time membership in a fitness centre. Comparison: received information about the content and purpose of the study with access to the website but no intervention | Objective | Aerobic Power Index submaximal aerobic exercise - VO2max |
aBruno et al 2017 [63] | Italy | Prospective RCT | 191 | Aged > 18 | BMI ≥ 25 | Not specified | Singleton | Not specified | PA intervention to develop a more active lifestyle (30mins of PA at least 3 times per week). Comparison: control group received a nutritional booklet which was in accordance with the Italian guidelines for diet and PA during pregnancy. All women the control group received antenatal care | Objective | Pedometer - Assess the number of steps and the duration of PA |
aVan Horn et al 2018 [59] | USA | RCT | 281 | Aged 18–45 | BMI 24–40 | < 16 weeks | Singleton | Fluent in English, smartphone | Intervention prescribed calorie goals based on height, pre-conception weight, PA level and energy needs relevant for restricted total GWG. Comparison: usual care received access to MOMFIT website | Objective | Pedometer or smartphone tracking device and to log their activity, minutes of activity or steps per day |
Kennelly et al 2018 [58] | Ireland | RCT | 565 | Aged 18–45 | BMI > 25–39.9 | Between 10 and 15 weeks | Not specified | Smartphone | Healthy lifestyle package, education session on nutrition and PA advice, healthy eating in pregnancy and benefits and safety of PA. Smartphone application reinforced the education and included 3 components; low glycaemic index recipes, exercise advice and nutritional exercise tips. Comparison: control group received standard antenatal care which in Ireland does not consist of any uniform advice | Self-report | International Physical Activity Questionnaire (IPAQ) |