Clinical Question

Does exercise during pregnancy decrease the risk of developing hypertensive disorders of pregnancy?

Evidence-Based Answer

Exercise regimens initiated early in pregnancy and performed consistently are an effective way to reduce a patient’s risk of developing gestational hypertension and preeclampsia. (Strength of Recommendation [SOR]: A, meta-analysis of randomized controlled trials [RCTs].) Aerobic exercise regimens initiated early in pregnancy and performed for at least 30 minutes three to four times per week reduce a patient’s risk of developing hypertensive disorders of pregnancy. (SOR: A, meta-analysis of RCTs.)

Evidence Summary

A 2018 systematic review and meta-analysis that included 106 unique RCTs and 273,182 pregnant patients analyzed the protective effect of exercise on preventing gestational hypertension and preeclampsia during pregnancy.¹ A pooled estimate from 22 of the RCTs with exercise-only interventions included in the meta-analysis (n = 5,316) found a 39% reduction in the odds of developing gestational hypertension (number needed to treat [NNT] = 63; Table 1^1–3). Another pooled estimate from 15 of the RCTs (n = 3,322) showed 41% lower odds of developing preeclampsia in the exercise-only intervention group vs. control groups that did not exercise (NNT = 93). A meta-regression analysis suggested that as little as 25 minutes of exercise three days per week could provide the above benefits.