Gestational hypertension is a notable concern with ramifications for maternal and fetal health. Preemptive measures, including physical activity (PA), are crucial. There is a pressing need for comprehensive investigations into the impact of various forms of PA on hypertensive disorders. A systematic review and meta-analysis (CRD42022372468) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Our review exclusively considered randomized clinical trials (RCTs) between 2010 and 2023, using the following databases: EBSCO, including Academic Search Premier, Education Resources Information Center, PubMed/Medline, SPORTDiscus, and OpenDissertations; ClinicalTrials.gov; Web of Science; Scopus; the Cochrane Database of Systematic Reviews; and the Physiotherapy Evidence Database (PEDro). The primary outcome was hypertensive disorders occurring during pregnancy (14 studies). Diagnosed preeclampsia (15 studies) and blood pressure levels were also examined (17 studies). PA during pregnancy was significantly associated with a reduced risk of hypertensive disorders (RR 0.44, 95% CI 0.30 to 0.66). The data also indicate a positive correlation between PA during pregnancy and both systolic (MD -2.64, 95% CI -4.79 to -0.49) and diastolic (MD -1.99, 95% CI -3.68 to -0.29) blood pressure levels. The relationship between PA and the incidence of diagnosed preeclampsia did not demonstrate a statistically significant association (RR 0.81, 95% CI 0.59 to 1.11; p = 0.20). Random effects were used for all analyses. PA during pregnancy promises to improve maternal health by reducing the risk of gestational hypertension and positively affecting systolic and diastolic blood pressure.

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