Abstract
Pregnancy issues such as gestational hypertension, preeclampsia, and gestational diabetes mellitus (GDM) are significant contributors to long-term cardiovascular diseases (CVDs) in women. Recent research has proved the impact of exercise on improving cardiovascular outcomes, particularly in women with pregnancy-related disorders. This review explores the outcomes of various exercise interventions on cardiovascular health in pregnant women. Among these, aerobic exercise has been widely studied, with results from observational studies and randomized controlled trials (RCTs) showing its positive outcomes on cardiovascular health in pregnant women, especially with complications. It has been found that regular aerobic exercise has been associated with reduced hypertension and improved endothelial function, particularly in women with a history of preeclampsia. Evidently, aerobic exercise results in better blood pressure regulation and enhanced vascular health that directly attends to the risk of cardiovascular diseases associated with pregnancy complications. Another form of exercise is resistance training, which despite being studied less, has shown potential benefits as well. Some advantages of resistance exercise have been found to improve muscle strength and overall enhancement in metabolic control. This is important, especially in women with GDM whereby improvement in insulin sensitivity reduces the overall risk of type 2 diabetes and future CVDs. Combined exercise that incorporates both aerobic and resistance elements has been known to offer the most comprehensive benefits. Various studies suggest that a combinatory approach maximizes the positive cardiovascular effects. Practicing women have experienced better overall heart health, with improved blood pressure regulation, enhanced endothelial function, and reduced metabolic risks. However, despite these findings, there are challenges such as small sample sizes and limited follow-up durations that hinder the generalizability of current research. Importantly, previous studies targeting exercise interventions for women experiencing complications during pregnancy have been limited in evidence by small sample sizes, short follow-ups, and lack of diversity. Such broader, more diverse populations were needed to reflect the various health risks and responses to exercise. Future research must include multi-center RCTs, diverse exercise regimens, and digital health tools for monitoring exercise adherence. This warrants future large-scale, multicenter trials that are necessary to establish more definitive evidence. Additionally, clinicians should consider including tailored exercise programs in care plans for women with pregnancy complications to mitigate long-term cardiovascular risks.