Impact of postpartum physical activity on maternal anthropometrics: a systematic review and meta-analysis

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