Pregnancy is a dynamic physiological process characterized by profound anatomical, hormonal, and metabolic changes. The maternal body undergoes significant adaptations to accommodate fetal development and prepare for childbirth. During this critical period, maternal health becomes a cornerstone of both maternal and fetal well-being, influencing not only the pregnancy course but also long-term health outcomes for both mother and child [1].

Physical activity is now increasingly recognized as a modifiable factor that can contribute positively to maternal health. It has been shown to improve cardiovascular fitness, maintain optimal weight gain, regulate blood glucose levels, and enhance psychological well-being during pregnancy [2]. Moreover, regular antenatal exercise has been associated with reduced risks of gestational diabetes mellitus (GDM), hypertensive disorders, preterm delivery, and cesarean section [3]. Despite these benefits, physical inactivity remains common among pregnant women, often due to safety concerns, lack of awareness, and inconsistent advice from healthcare providers [4].

The American College of Obstetricians and Gynecologists (ACOG) recommends that, in the absence of medical contraindications, pregnant women should engage in at least 150 minutes of moderate-intensity aerobic activity per week [5]. However, actual adherence to this recommendation varies widely based on socioeconomic, educational, and cultural factors, particularly in low- and middle-income countries where antenatal physical activity is not routinely integrated into maternal care [6].

Maternal health indicators such as gestational weight gain, blood pressure regulation, and incidence of common obstetric complications have shown measurable improvements with structured physical activity programs [7]. Furthermore, fetal outcomes, including birth weight, Apgar scores, and neonatal morbidity, appear to benefit indirectly from enhanced maternal metabolic and vascular function [8]. Some studies also highlight psychological benefits of physical activity, including reductions in perinatal depression, anxiety, and sleep disturbances, which further underscore its holistic impact [9].

Despite growing evidence, clinical data on the role of physical activity in improving pregnancy outcomes in real-world settings remains underreported, especially in resource-limited environments. This study was undertaken to clinically evaluate the impact of antenatal physical activity on maternal health status and pregnancy outcomes, providing data that can guide future antenatal care protocols and health education strategies [10].

Study Design and Setting

This was a hospital-based prospective clinical study conducted over a period of 12 months in the Department of Obstetrics and Gynecology at a tertiary care center. The primary aim was to evaluate the effect of physical activity during pregnancy on maternal health indicators and pregnancy outcomes.

Sample Size and Selection Criteria

A total of 200 pregnant women in their first or early second trimester (up to 20 weeks of gestation) were enrolled. Participants were selected using systematic random sampling from the antenatal outpatient department. Written informed consent was obtained from all participants.

Inclusion criteria:

• Singleton pregnancy
• Age between 20 and 35 years
• No contraindication to physical activity
• Willingness to participate and comply with follow-up

Exclusion criteria:

• High-risk pregnancies (e.g., placenta previa, preeclampsia, threatened abortion)
• Pre-existing chronic illnesses (e.g., uncontrolled diabetes, cardiac disorders)
• History of recurrent pregnancy loss
• Participants already on structured fitness programs or undergoing physiotherapy

Grouping

Participants were divided into two groups:

• Group A (Active group): Engaged in moderate physical activity at least 3–5 times per week for 30–45 minutes. Activities included brisk walking, prenatal yoga, and supervised stretching routines.
• Group B (Sedentary group): Did not engage in any structured or regular physical activity beyond routine daily household movements.

Compliance with activity was monitored through a structured antenatal logbook and monthly follow-up interviews.

Data Collection Tools

Maternal health indicators assessed included:

• Weight gain during pregnancy
• Blood pressure monitoring
• Blood glucose levels (FBS, OGTT as per IADPSG criteria)
• Hemoglobin levels
• Assessment of edema, fatigue, and musculoskeletal complaints

Pregnancy outcomes evaluated were:

• Gestational age at delivery
• Mode of delivery (vaginal vs. cesarean)
• Neonatal birth weight
• APGAR scores at 1 and 5 minutes
• Incidence of pregnancy complications (GDM, PIH, preterm labor)

Data were collected using structured case sheets, validated antenatal records, and delivery summaries.

Statistical Analysis

Data analysis was performed using SPSS version 26. Descriptive statistics were used to summarize demographic and clinical characteristics. Categorical variables were compared using the Chi-square test, and continuous variables using the independent t-test or Mann–Whitney U test where applicable. A p-value <0.05 was considered statistically significant.

Ethical Considerations

Ethical clearance for the study was obtained from the Institutional Ethics Committee. Confidentiality of participant data was maintained throughout the study, and participation was voluntary.

Women who engaged in regular physical activity (Group A) had significantly lower gestational weight gain, better hemoglobin levels, and more favorable blood pressure and blood sugar values compared to sedentary women. These findings indicate better maternal health profiles associated with physical activity.

Table 1: Comparison of Maternal Health Parameters between Active and Sedentary Groups

The active group had significantly fewer instances of GDM, PIH, and anemia compared to the sedentary group. Although the difference in preterm labor was not statistically significant, a favorable trend was observed in the active group.

Table 2: Pregnancy Complications in Both Groups

Newborns from the physically active mothers had higher mean birth weights and a significantly lower incidence of low birth weight. Although APGAR scores were better in the active group, the differences were not statistically significant.

Table 3: Neonatal Outcomes

The rate of normal vaginal delivery was significantly higher in the active group, with a corresponding lower rate of cesarean sections. This suggests that maternal physical activity may contribute to improved labor outcomes and reduce surgical interventions.

Table 4: Mode of Delivery

The findings of this clinical study demonstrate a significant association between regular physical activity during pregnancy and improved maternal health as well as favorable pregnancy outcomes. Women in the active group exhibited better physiological profiles, including controlled gestational weight gain, higher hemoglobin levels, lower systolic blood pressure, and better glycemic control when compared to their sedentary counterparts. These results are consistent with previous clinical evidence supporting the protective effects of antenatal exercise on maternal metabolic health [11].

Gestational weight gain is a critical factor influencing pregnancy complications such as gestational diabetes and hypertensive disorders. In this study, the active group maintained weight gain within recommended limits, while the sedentary group showed significantly higher values. Regular moderate exercise improves insulin sensitivity and enhances lipid metabolism, thereby mitigating risks of excessive weight gain and glucose intolerance [12]. The significantly lower fasting blood sugar and reduced incidence of gestational diabetes in the physically active group further support this physiological mechanism [13].

Hypertensive disorders of pregnancy continue to be a leading cause of maternal morbidity and mortality. Physical activity contributes to better vascular compliance and blood pressure regulation by modulating endothelial function and autonomic balance [14]. In our findings, the prevalence of pregnancy-induced hypertension was significantly lower among active women. These findings affirm that structured physical activity can play a preventive role in managing blood pressure, especially in the third trimester [15].

Anemia in pregnancy has multifactorial etiology, but improved dietary absorption, reduced inflammation, and enhanced circulation associated with exercise may explain the better hemoglobin levels observed in the active group. Additionally, fewer reports of fatigue and musculoskeletal complaints were documented among women in this group, which may contribute to an overall improved quality of life and functional ability during pregnancy [16].

Regarding neonatal outcomes, babies born to active mothers had significantly higher mean birth weights and lower rates of low birth weight, without an increase in macrosomia. These outcomes suggest that physical activity enhances placental function and nutrient transport without compromising fetal safety [17]. Although the difference in APGAR scores between the groups did not reach statistical significance, the active group trended toward better neonatal adaptation, indicating no adverse impact of maternal activity on immediate neonatal well-being [18].

The mode of delivery is another important maternal outcome. Our study observed a higher incidence of normal vaginal deliveries and a lower rate of cesarean sections among women who exercised regularly. Physical activity improves pelvic floor muscle tone, pain tolerance, and stamina, thereby facilitating natural labor and reducing the need for operative intervention [19].

Despite its strengths, the study has some limitations. It was conducted in a single tertiary care center, which may limit the generalizability of results to rural or lower-resource settings. The assessment of physical activity was partly based on self-reports, which may introduce recall bias. However, monthly follow-ups and logbook monitoring helped reduce this potential source of error. Future studies could incorporate wearable activity trackers and explore long-term maternal and child health outcomes [20-22].

This study highlights the beneficial role of regular physical activity during pregnancy in improving maternal health and pregnancy outcomes. Women who engaged in consistent antenatal exercise experienced better weight control, lower blood pressure, improved hemoglobin levels, and reduced incidence of gestational diabetes and hypertension. Additionally, their newborns had higher birth weights and better chances of vaginal delivery. These findings support the integration of structured physical activity programs into routine prenatal care. Educating pregnant women about the safety and advantages of physical activity can lead to healthier pregnancies and reduce the burden of preventable obstetric complications.

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