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Review
. 2024 May 17:15:1394707.
doi: 10.3389/fphys.2024.1394707. eCollection 2024.

Impact of maternal posture on fetal physiology in human pregnancy: a narrative review

Allan J Kember  1   2 , Jennifer L Anderson  3 , Sarah C House  4 , David G Reuter  5 , Craig J Goergen #  6 , Sebastian R Hobson #  1   7   8
Affiliations
Review

Impact of maternal posture on fetal physiology in human pregnancy: a narrative review

Allan J Kember et al. Front Physiol. .

Abstract

In numerous medical conditions, including pregnancy, gravity and posture interact to impact physiology and pathophysiology. Recent investigations, for example, pertaining to maternal sleeping posture during the third trimester and possible impact on fetal growth and stillbirth risk highlight the importance and potential clinical implications of the subject. In this review, we provide an extensive discussion of the impact of maternal posture on fetal physiology from conception to the postpartum period in human pregnancy. We conducted a systematic literature search of the MEDLINE database and identified 242 studies from 1991 through 2021, inclusive, that met our inclusion criteria. Herein, we provide a synthesis of the resulting literature. In the first section of the review, we group the results by the impact of maternal posture at rest on the cervix, uterus, placenta, umbilical cord, amniotic fluid, and fetus. In the second section of the review, we address the impact on fetal-related outcomes of maternal posture during various maternal activities (e.g., sleep, work, exercise), medical procedures (e.g., fertility, imaging, surgery), and labor and birth. We present the published literature, highlight gaps and discrepancies, and suggest future research opportunities and clinical practice changes. In sum, we anticipate that this review will shed light on the impact of maternal posture on fetal physiology in a manner that lends utility to researchers and clinicians who are working to improve maternal, fetal, and child health.

Keywords: gravity; maternal; obstetrics; pathophysiology; physiology; posture; pregnancy.

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Conflict of interest statement

Author AK was employed by Shiphrah Biomedical Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram outlining the study selection process.
FIGURE 2
FIGURE 2
Summary diagram of changes in uterine, placental, umbilical cord, and fetal physiology observed in the maternal supine posture compared to lateral postures.
See this image and copyright information in PMC

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References

    1. Abaci T. E., Abulnaga S. M., Luo J., Stout J. N., Feldman H. A., Turk A., et al. (2020). Placental MRI: effect of maternal position and uterine contractions on placental BOLD MRI measurements. Placenta 95, 69–77. 10.1016/j.placenta.2020.04.008 - DOI - PMC - PubMed
    1. Abeysena C., Jayawardana P., Seneviratne R., de A. (2010b). Effect of psychosocial stress and physical activity on low birthweight: a cohort study. J. Obstet. Gynaecol. Res. 36 (2), 296–303. 10.1111/j.1447-0756.2009.01155.x - DOI - PubMed
    1. Abeysena C., Jayawardana P., Seneviratne R. de A. (2010a). Effect of psychosocial stress and physical activity on preterm birth: a cohort study. J. Obstet. Gynaecol. Res. 36 (2), 260–267. 10.1111/j.1447-0756.2009.01160.x - DOI - PubMed
    1. Abou-Setta A. M., Peters L. R., D’Angelo A., Sallam H. N., Hart R. J., Al-Inany H. G. (2014). Post-embryo transfer interventions for assisted reproduction technology cycles. Cochrane Database Syst. Rev. (8), CD006567. 10.1002/14651858.CD006567.pub3 - DOI - PMC - PubMed
    1. Agopian A. J., Kim J., Langlois P. H., Lee L., Whitehead L. W., Symanski E., et al. (2017). Maternal occupational physical activity and risk for orofacial clefts. Am. J. Ind. Med. 60 (7), 627–634. 10.1002/ajim.22731 - DOI - PMC - PubMed

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This publication was made possible in part, by support from the Department of Obstetrics and Gynaecology at Mount Sinai Hospital (Toronto, Canada), a Bill and Melinda Gates Foundation Global Grand Challenges Grant (OPP1182739; Funder ID: 10.13039/100000865), and the Purdue Women’s Global Health Institute, and the Indiana Clinical and Translational Sciences Institute (Funder ID: 10.13039/100006975). The Indiana CTSI is funded in part by Award No. UL1TR002529 from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.