Structured exercise may improve blood pressure and outcomes in hypertensive disorders of pregnancyStructured exercise may help manage high blood pressure during pregnancy

BackgroundHypertensive disorders of pregnancy (HDP) are one of the leading causes of maternal and fetal morbidity and mortality worldwide. Although prenatal physical activity is broadly recommended for uncomplicated pregnancies, evidence regarding exercise prescription, safety monitoring, and clinically relevant outcomes among women at risk of or diagnosed with HDP remains insufficiently mapped.ObjectiveTo map the existing literature on structured exercise interventions for the prevention and management of HDP and to identify gaps for future research.MethodsThis scoping review was conducted in accordance with PRISMA-ScR. Four electronic databases (PubMed, Embase, Web of Science, and the Cochrane Library) and two trial registries (the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov) were searched from inception to December 19, 2025. Eligible studies evaluated structured exercise interventions in pregnant women diagnosed with HDP or at high risk of developing HDP. Two reviewers independently screened studies and extracted data using a predefined form. Extracted information included study design, participant characteristics, intervention characteristics, outcomes, and findings.ResultsThirteen articles published between 2008 and 2025 were included. The included articles primarily involved two clinical contexts: women at high risk of HDP and women with established HDP. The interventions included aerobic exercise, resistance training, combined aerobic and resistance exercise, stretching, and yoga. Overall, most studies reported that structured exercise interventions may improve blood pressure control, reduce the risk of certain HDP-related events, and improve pregnancy and neonatal outcomes, endothelial function, and maternal psychological well-being. However, the current evidence remains limited by substantial heterogeneity in the prescription parameters of exercise interventions. In particular, the definition, classification, and monitoring of exercise intensity were insufficiently operationalized across studies. In addition, safety monitoring, exercise termination criteria, adherence, and intervention fidelity were inadequately reported, and some studies used statistical methods that did not fully account for pre–post or repeated-measures designs.ConclusionsAvailable evidence on structured exercise interventions for HDP is limited, heterogeneous, and insufficient to inform population-specific exercise prescriptions. Future trials should adopt more rigorous designs, clearly define and monitor exercise intensity, improve statistical approaches, and include safety, adherence, and clinically meaningful maternal and neonatal outcomes.Systematic Review Registrationhttps://doi.org/10.17605/OSF.IO/DPVH3, identifier 10.17605/OSF.IO/DPVH3.