Pregnancy-induced gait alterations : meta-regression evidence of spatiotemporal adjustments

Abstract

During pregnancy, women undergo significant physiological, hormonal, and biomechanical changes that influence their gait. The forward shift of the center of mass and increased joint loads often result in a waddling gait, elevating the risk of falls. While gait changes during pregnancy have been documented, findings across studies remain inconsistent, particularly regarding variations at different pregnancy stages. This systematic review and meta-analysis aimed to quantify the impact of pregnancy stages on spatiotemporal gait parameters. A comprehensive literature search across six databases (PubMed, Web of Science, Scopus, EBSCO, Embase, and Cochrane Library) was conducted to identify studies on pregnancy and gait, and data on publication details, methodology, participant characteristics, gait outcomes, and study limitations were extracted. Out of 4,581 initial records, 21 studies met the inclusion criteria. The meta-analysis revealed significant changes in gait parameters during pregnancy, with decreases in stride length (effect size = -0.29) and gait speed (effect size = -0.55), and increases in stride width (effect size = 0.45), cycle time (effect size = 0.38), and double support time (effect size = 0.41). Meta-regression analyses indicated that gestational weeks significantly impacted stride length (beta = -0.03 [95% CI, -0.055 to -0.002], p < 0.05) and stride width (beta = 0.02 [95% CI, 0.003 to 0.039], p < 0.05), while no significant effects were found for cycle time, double support time, or gait speed. In conclusion, pregnancy leads to significant changes in gait patterns, with a notable increase in stride width and a decrease in stride length as gestation progresses, suggesting these adjustments are strategies for maintaining balance and stability in response to physiological changes. The analysis also emphasizes that while gestational age influences gait adaptations, other factors such as pelvic girdle pain, footwear, and psychological influences play crucial roles. Understanding these complex gait changes can inform interventions and guidelines to support mobility and safety for pregnant women throughout their pregnancy.