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Systematic review
Impact of postpartum physical activity on maternal anthropometrics: a systematic review and meta-analysis
  1. Matthew J Gervais1,
  2. Stephanie-May Ruchat2,
  3. Muhammad Usman Ali3,
  4. Talia Sjwed1,
  5. Brittany A Matenchuk1,
  6. Sarah Meyer1,
  7. Michelle F Mottola4,
  8. Kristi B Adamo5,
  9. Allison Sivak6,
  10. Margie H Davenport1
  1. 1 Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
  2. 2 Département des sciences de l’activité physique, Université du Québec à Trois-Rivières, Trois-Rivieres, Quebec, Canada
  3. 3 McMaster Evidence Review and Synthesis Centre and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
  4. 4 R. Samuel McLaughlin Foundation- Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children’s Health Research Institute, The University of Western Ontario, London, Ontario, Canada
  5. 5 Prevention in the Early Years Lab, Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
  6. 6 Geoffrey & Robyn Sperber Library, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to Dr Margie H Davenport; mdavenpo{at}ualberta.ca

Abstract

Objective This systematic review and meta-analysis examined the relationship between postpartum exercise and maternal postpartum anthropometrics.

Design Systematic review with random-effects meta-analysis and meta-regression.

Study eligibility criteria Online databases were searched from database inception until 12 January 2024. Randomised controlled trials (RCTs) written in any language were eligible if they contained information on the population (postpartum women and people); intervention (frequency, intensity, duration, volume or type of exercise, alone (‘exercise-only’) or in combination with other interventions (eg, dietary; ‘exercise+cointervention’)); comparator (no exercise) and outcomes (anthropometric measures including weight, postpartum weight retention (PPWR), body mass index (BMI), fat mass, lean body mass (LBM), body fat percentage, waist circumference, hip circumference or waist–hip ratio).

Results 64 RCTs (n=12 684 participants) from 20 countries were included. Moderate to high certainty of evidence showed that exercise-only interventions reduced weight by 1.34 kg (18 studies, n=771; 95% CI −2.06 to –0.61, I2 0%), BMI by 0.73 kg/m2 (14 studies, n=662; 95% CI −1.21 to –0.25, I2 60%) and fat mass by 1.55 kg (5 studies, n=135; 95% CI −3.01 to –0.09, I2 0%) compared with no exercise. The duration of the exercise interventions ranged from 3 months to 3 years. Dose–response analysis found 560 MET-min/week of exercise (eg, 120 min/week of brisk walking) was associated with 1 kg/m2 reduction in BMI. Low certainty of evidence showed that exercise-only interventions had no effect on LBM (5 RCTs, n=135; standardised mean difference −0.13; 95% CI −0.48, 0.21, I2 0%) compared with no exercise.

Conclusions These findings highlight physical activity as an effective intervention to improve postpartum anthropometrics and reduce PPWR.

PROSPERO registration number CRD42022359282.

  • Exercise
  • Body weight regulation
  • Meta-analysis

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/bjsports-2024-108449

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • X @ExercisePreg

    • Contributors MHD, S-MR, MUA, MFM and KA contributed to the conception of the study. MHD, S-MR, MUA, and AS contributed to the design of the study and development of the search strategy. AS conducted the systematic search. MJG, TS, BAM, and SM completed the acquisition of data. MJG, TS, BAM and SM performed the data analysis. MHD, S-MR, MUA and MJG assisted with the interpretation. MJG and MHD were the principal writers of the manuscript. All authors contributed to the drafting and revision of the final article. All authors approved the final submitted version of the manuscript. MHD is the guarantor.

    • Funding MJG is funded by an Alberta Innovates—Health Solutions Summer Studentship. BAM is supported by a CIHR Canadian Graduate Scholarship—Doctoral and Women and Children’s Health Research Institute Graduate Student Scholarship. SMR is funded by the Université du Québec à Trois-Rivières research chair in physical activity and maternal and neonatal health. MHD is funded by a Christenson Professorship in Active Healthy Living.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.