Study Identifies 6 Components of a Pregnancy Exercise Program that Reduce Risk of Poor Perinatal Outcomes
While exercise is beneficial during pregnancy and ACOG recommends 150 mins/week, this is the first study to examine benefits of specific regimen elements on their own.
A structured exercise program developed around 6 key components, including initiation in the first trimester of pregnancy, combining aerobic and muscle-strengthening activities, and of light-to-moderate intensity, may help improve perinatal outcomes such as gestational diabetes mellitus (GDM), excessive gestational weight gain (eGWG), and hypertensive disorders of pregnancy (HDP), according to new research.1
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Findings of the systematic review and meta-analysis of the most effective exercise interventions during pregnancy were presented at the 2025 American College of Obstetricians and Gynecologists (ACOG) annual Clinical & Scientific Meeting, May 16-18, 2025, in Minneapolis, MN.
The ACOG recommends that women participate in 150 minutes of moderate-intensity aerobic exercise per week during pregnancy, but the specific types of exercise and other components of a regimen that would be most beneficial during gestation to reduce risk of poor perinatal outcomes is less clear, according to presenting author Sara Sauer, PhD, senior data scientist at Delfina Care, in San Francisco, and colleagues.1
To add to the body of evidence for regular physical activity, Sauer et al analyzed 43 randomized controlled trials encompassing 8,451 pregnancies. Of these, 26 studies (n=6,279) evaluated outcomes related to GDM, 24 studies (n=5,536) assessed eGWG, and 13 studies (n=3,002) focused on HDP. They found that to help prevent GDM:
- Light-to-moderate exercise intensity was most effective (OR 0.46; 95% CI, 0.32–0.66).
- Interventions that began in the first trimester (OR 0.49; 95% CI, 0.38–0.63) and used combined aerobic and resistance training (OR 0.51; 95% CI, 0.39–0.67) were also associated with reduced GDM risk.
- Use of a mobile app or other type of activity monitor for additional support further also reduced odds (OR 0.51; 95% CI, 0.41–0.64).
- Effective session structure included durations of 45 minutes or more (OR 0.54; 95% CI, 0.42–0.71) and a frequency of 3 or more days per week (OR 0.55; 95% CI, 0.36–0.84).
The findings were consistent for reducing the risk of eGWG and HDP, according to the study abstract.1
The research team included randomized controlled studies of exercise-only interventions during pregnancy in the analysis. For each of the 3 outcomes of interest, they conducted a separate meta-analysis for each exercise component (type, trimester of start, mobile application/activity monitor support, intensity, session duration, session frequency). Results allowed them to estimate and rank the effectiveness of each value of the component on the outcome, relative to control group participants.1
The authors conclude that the 6 components provide a replicable framework for designing prenatal fitness programs that yield measurable perinatal health benefits. This evidence offers more precise, evidence-based guidance to augment current ACOG recommendations, they wrote in the study abstract.1
ACOG recommends several precautions women should take during sessions of physical activity including remaining hydrated before, during, and after a workout, avoiding becoming overheated during exercise, particularly during the first trimester, and avoiding standing or lying flat on the back, the former to prevent the uterus from restricting blood flow back to the heart and the latter to prevent blood from pooling in legs and feet.2
Check out all the Patient Care ACOG 2025 coverage.
