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Am Fam Physician. 2022;106(1):87-88

Author disclosure: No relevant financial relationships.

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 113). 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.

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Clinical Inquiries provides answers to questions submitted by practicing family physicians to the Family Physicians Inquiries Network (FPIN). Members of the network select questions based on their relevance to family medicine. Answers are drawn from an approved set of evidence-based resources and undergo peer review. The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the Evidence-Based Medicine Working Group (

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