Impact of exercise training during pregnancy on maternal biomarkers: a systematic review.

Abstract

The aim of this systematic review was to identify and analyze biomarkers that are influenced by physical exercise during pregnancy and that contribute to maternal-fetal health and development. A comprehensive systematic search of PubMed, Web of Science, and Elton B. Stephens Company Host databases was conducted without time restriction in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO ID: CRD420251017740). Eligible studies were randomized controlled trials examining the effects of exercise interventions during pregnancy on biomarkers measured in maternal serum, umbilical cord blood, breast milk, and placental tissue. Eleven randomized controlled trials meeting the inclusion criteria were analyzed. The effects of different exercise modalities, durations, and intensities on a wide range of biomarkers were evaluated. Exercise interventions performed for 12 weeks or longer with 2 to 3 weekly sessions at moderate-to-vigorous intensity, demonstrated substantial effects on several biomarkers. These included a reduction in proinflammatory markers (TNF-α, interleukin 6), an increase in antiinflammatory cytokines (interleukin 10), improved lipid profiles (lower low-density lipoprotein, triglycerides), improved glucose regulation, and favorable changes in hormonal markers such as leptin and brain-derived neurotrophic factor. Additionally, exercise was associated with positive changes in umbilical cord blood cytokines, immunologic composition of breast milk, and placental mineral content. Structured exercise programs during pregnancy, particularly resistance training and aerobic exercise performed in the same session, show promising effects on modulating inflammatory, metabolic, and immunologic biomarkers that may contribute to improved maternal-fetal health outcomes. However, current evidence is limited by methodological heterogeneity and lack of data from early pregnancy.