Preeclampsia is among the most common hypertensive disorders of pregnancy and remains a leading cause of maternal and neonatal morbidity and mortality. Increasing evidence suggests that regular physical activity during pregnancy may confer a protective effect; however, findings across studies are not fully consistent. This study systematically reviewed existing evidence on the association between physical activity/exercise during pregnancy and the risk of preeclampsia, based on 12 eligible studies. The review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Scopus, Web of Science, the Cochrane Library, Google Scholar, and national databases were searched without language restrictions. Observational studies, interventional trials, and evidence syntheses evaluating physical activity in relation to preeclampsia were considered. Study quality was assessed using RoB 2 and the Newcastle–Ottawa Scale, and due to substantial heterogeneity in exposure definitions and study designs, findings were synthesized narratively. Overall, most studies reported that light-to-moderate physical activity—particularly regular aerobic exercise or recreational activity initiated in early pregnancy—was associated with a lower risk of preeclampsia, whereas sedentary behavior and prolonged sitting were identified as independent risk factors. Some studies also suggested that physical activity may influence pathways implicated in preeclampsia, including angiogenic balance and inflammatory processes. In conclusion, physical activity during pregnancy appears to be a safe, low-cost, and feasible strategy that may reduce the risk of preeclampsia; nevertheless, well-designed interventional studies are needed to define the optimal type, intensity, and timing of exercise initiation.

Preeclampsia Physical activity Prenatal exercise Maternal health Systematic review