{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:06:38Z","timestamp":1790870798233,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness and safety of a supervised multicomponent exercise program performed throughout uncomplicated pregnancy on delivery outcomes, with particular emphasis on cesarean section rates and miscarriage risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomized clinical trial (NCT04563065) was conducted. A total of 400 pregnant women were assessed for eligibility, and data from 256 participants were analyzed, including 120 women in the exercise group (EG) and 136 in the control group (CG). Women allocated to the EG participated in a supervised, moderate\u2010intensity, multicomponent hybrid (face\u2010to\u2010face and online) group exercise program performed three times per week (60\u2009min\/session) from 8 to 10 until 38\u201340\u2009weeks of gestation. A minimum adherence of 75% was required for inclusion in the final per\u2010protocol analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among women who completed pregnancy, those in the EG had a significantly lower cesarean section rate than those in the CG (12.6% vs. 28.9%, \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200910.42,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Exercise participation was not associated with an increased risk of miscarriage (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.000), and no significant differences were observed between groups in instrumental vaginal delivery or other maternal and neonatal outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Participation in a supervised, moderate\u2010intensity multicomponent exercise program throughout pregnancy reduced cesarean section rates without increasing miscarriage risk, supporting its incorporation into routine prenatal care as a safe and effective non\u2010pharmacological strategy for improving delivery outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/birt.70098","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T03:16:15Z","timestamp":1785467775000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Supervised Multicomponent Exercise During Pregnancy Reduces Cesarean Section Rates Without Increasing Miscarriage Risk: A Randomized Clinical Trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3386-7036","authenticated-orcid":false,"given":"Dingfeng","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Physical Education and Sports Science South China Normal University  Guangzhou China"},{"name":"AFIPE Research Group, Faculty of Physical Activity and Sports Science Universidad Polit\u00e9cnica de Madrid  Legan\u00e9s Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3906-3669","authenticated-orcid":false,"given":"Miguel","family":"S\u00e1nchez\u2010Pol\u00e1n","sequence":"additional","affiliation":[{"name":"GICAF Research Group, Department of Education, Research and Evaluation Methods Universidad Pontificia Comillas  Legan\u00e9s Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9134-2011","authenticated-orcid":false,"given":"Cristina","family":"Silva\u2010Jose","sequence":"additional","affiliation":[{"name":"AFIPE Research Group, Faculty of Physical Activity and Sports Science Universidad Polit\u00e9cnica de Madrid  Legan\u00e9s Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5424-7525","authenticated-orcid":false,"given":"\u00c1ngeles","family":"D\u00edaz\u2010Blanco","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Department Hospital Universitario Severo Ochoa de Legan\u00e9s  Legan\u00e9s Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aranzazu Mart\u00edn","family":"Arias","sequence":"additional","affiliation":[{"name":"Obstetrics Department Hospital Universitario de Torrej\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1851-7940","authenticated-orcid":false,"given":"Paloma","family":"Hernando","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics Department Hospital Universitario Puerta de Hierro de Majadahonda  Legan\u00e9s Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Montejo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Obstetrics and Gynecology, Institute of Clinical 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