Pilates exercise in pregnancy: a systematic review and meta-analysis

BackgroundPilates is widely acknowledged as an effective exercise for enhancing physical, psychological, and motor functions. However, there remains ongoing debate regarding the effects of Pilates on pregnancy outcomes. Thus, the objective of this systematic review was to evaluate and critically analyze the existing scientific evidence regarding the effects of Pilates on pregnant women.MethodsA thorough search was performed across 7 databases, focusing on articles published up to June 2024. The quality of evidence was assessed using the Cochrane RoB Tool, and STATA 17.0 software was utilized to perform tests for heterogeneity, publication bias, and sensitivity analysis.Results(1) A total of 11 studies were included in this review, comprising 538 participants. Among these, 3 studies exhibited a low risk of bias, while 8 studies presented an unclear risk of bias. (2) The meta-analysis results indicated that Pilates exercise resulted in non-significant changes in the Body Mass Index (BMI) of pregnant women (SMD 0.02; 95% CI, -0.27 to 0.31; P = 0.887), the body weight of pregnant women (SMD 0.25; 95% CI, -0.52 to 1.02; P = 0.519), the mode of delivery (RR 1.41; 95% CI, 0.95 to 2.09; P = 0.093), and the Low-density lipoprotein (LDL) levels of pregnant women (SMD - 1.182; 95% CI, -2.443 to 0.079; P = 0.066). However, Pilates exercise during pregnancy was associated with significant improvements in APGAR scores at 1 min (SMD 0.41; 95% CI, 0.08 to 0.74; P = 0.015), a reduction in the duration of labor (SMD - 0.557; 95% CI, -0.915 to -0.198; P = 0.002), and a decrease in the Visual Analogue Score (VAS) score (SMD - 0.76; 95% CI, -1.45 to -0.07; P = 0.032). (3) Sensitivity analysis revealed no significant differences in effect size before and after the removal of any individual study, indicating that the meta-analysis results were stable.ConclusionsThis systematic review and meta-analysis demonstrate that Pilates during pregnancy positively influences the shortening of labor duration, improves the newborn's immediate physiological status, and alleviates labor pain.Trial registrationThe study was registered on the International Prospective Registry of Systematic Reviews--PROSPERO database (CRD42023393309) on January 30, 2023.