Encouraging New Moms to Move More: Are We Missing the Mark? A Systematic Review and Meta-Analysis on the Effect of Exercise Interventions on Postpartum Physical Activity Levels and Cardiorespiratory Fitness

Abstract

OBJECTIVE: To determine if current exercise interventions were effective at improving physical activity (PA) levels and/or cardiorespiratory fitness (CRF) in postpartum women. DESIGN: Intervention systematic review with meta-analysis. REGISTRATION: PROSPERO #CRD42022379855. LITERATURE SEARCH: CINAHL, Embase, Medline, PsycINFO and SportDiscus, searched from inception to March 2024. STUDY SELECTION CRITERIA: Participants: postpartum women, intervention: exercise, control: standard care, outcomes: PA levels and/or CRF. DATA SYNTHESIS: Random effects meta-analysis using standardized mean differences (SMD). Risk of bias was assessed using the Cochrane Risk of Bias 2 and Risk of Bias in Non-Randomised Studies-Intervention. RESULTS: 6041 studies were screened and 29 were eligible for inclusion. Nineteen studies with adequate control data included outcomes related to PA levels (n=12) or CRF (n=7) and were pooled in meta-analyses. There was a small to moderate improvement in CRF [SMD (95% CI) 0.65, (0.20, 1.10), I2=61%]. There was no improvement in PA levels [−0.13, (−0.53, 0.26), I2=90%]. Frequency, intensity, type, and time of the exercise interventions varied. Twenty-three studies were at high or serious risk of bias. CONCLUSIONS: Postpartum exercise interventions may improve CRF but have an unclear effect on PA levels. Despite numerous exercise interventions to improve health outcomes postpartum, parameters were inconsistent.