Background The prevalence of excessive gestation weight gain, extended postpartum weight retention and pregravid obese women is increasing and is associated with numerous adverse health outcomes.

Objective To review the evidence from studies employing exercise-only interventions for weight management among pregnant and postpartum women.

Search strategy Ten databases were searched for randomised controlled trials conducted during pregnancy or within the 12 months following childbirth and published between 1990 and 2013.

Selection criteria There were no restrictions to the type, frequency, duration or intensity of exercise intervention. Interventions not specifically designed to target weight were excluded. The outcomes were a change in body weight (kg) or body mass index (BMI; kg/m²).

Data collection and analysis All data were continuous and were reported as weighted mean differences (WMD), with 95% CIs. Data were analysed with a fixed-effect model and heterogeneity was determined using the I² statistic.

Results Five studies were included in this review. Exercise significantly reduced gestational weight gain (WMD=−2.22 kg, CI −3.14 to −1.3, p≤0.00001) and had no significant effect on postpartum weight loss (WMD=−1.74 kg, CI −3.59 to 0.10, p=0.06) or BMI during pregnancy (WMD=−2.8 kg/m², CI −5.60 to 0.00, p=0.05) or postpartum (WMD=−0.54 kg/m², CI −1.17 to 0.08, p=0.09).

Conclusions There is currently limited evidence to suggest that exercise can be used to limit maternal gestational weight gain.