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Exercise during pregnancy: a comparative review of guidelines

Ioannis Tsakiridis, Dimitra Rafailia Bakaloudi, Artemis Christina Oikonomidou, Themistoklis Dagklis and Michail Chourdakis

Abstract

Exercise during pregnancy may be beneficial provided that there are no contraindications. The aim of this study was to summarize and compare recommendations regarding exercise in pregnancy. Thus, a comparative descriptive review was conducted and included guidelines by the American College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynaecologists of Canada and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. All compared guidelines recommend that pregnant women without contraindications should undertake physical activities regularly, however, the type of workout performed should be adjusted based on the previous exercise experience and the physical condition of each pregnant woman. A variation among the reviewed guidelines was identified on appropriate and inappropriate activities and on indications to interrupt exercise. To summarize, the adoption of an international up-to-date consensus regarding appropriate exercise during pregnancy may be beneficial in ensuring the safety of the pregnant women while promoting their physical and mental health.


Corresponding author: Michail Chourdakis, School of Medicine, Facutly of Health Sciences, Aristotle University, University Campus, 54124, Thessaloniki, Greece, Phone: +30 2310 999035; Fax: +30 2312 205270, E-mail:

Ioannis Tsakiridis and Dimitra Rafailia Bakaloudi share first authorship.


  1. Research funding: None declared.

  2. Author contributions: Ioannis Tsakiridis developed the original idea for the study and participated in the manuscript writing. Dimitra Rafailia Bakaloudi and Artemis Christina Oikonomidou evaluated the data and participated in the manuscript writing. Themistoklis Dagklis supervised the manuscript development. Michail Chourdakis supervised the manuscript development, participated in the revision and submitted the article. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  3. Competing interests: Authors state no conflict of interest.

References

1. Piercy, KL, Troiano, RP, Ballard, RM, Carlson, SA, Fulton, JE, Galuska, DA, et al. The physical activity guidelines for americans. Jama 2018;320:2020–8. https://doi.org/10.1001/jama.2018.14854.Search in Google Scholar

2. RANZCOG. Exercise during pregnancy 2016:14.Search in Google Scholar

3. ACOG Committee Opinion No. 650. Physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol 2015;126:e135–42.Search in Google Scholar

4. Lokey, EA, Tran, ZV, Wells, CL, Myers, BC, Tran, AC. Effects of physical exercise on pregnancy outcomes: a meta-analytic review. Med Sci Sports Exerc 1991;23:1234–9; https://doi.org/10.1249/00005768-199111000-00006.Search in Google Scholar

5. South-Paul, JE, Rajagopal, KR, Tenholder, MF. The effect of participation in a regular exercise program upon aerobic capacity during pregnancy. Obstet Gynecol 1988;71:175–9.Search in Google Scholar

6. Szymanski, LM, Satin, AJ. Exercise during pregnancy: fetal responses to current public health guidelines. Obstet Gynecol 2012;119:603–10. https://doi.org/10.1097/AOG.0b013e31824760b5.Search in Google Scholar

7. Black, RA, Whitlock, BK, Krawczel, PD. Effect of maternal exercise on calf dry matter intake, weight gain, behavior, and cortisol concentrations at disbudding and weaning. J Dairy Sci 2017;100:7390–400. https://doi.org/10.3168/jds.2016-12191.Search in Google Scholar

8. Halse, RE, Wallman, KE, Dimmock, JA, Newnham, JP, Guelfi, KJ. Home-based exercise improves fitness and exercise attitude and intention in women with GDM. Med Sci Sports Exerc 2015;47:1698–704. https://doi.org/10.1249/MSS.0000000000000587.Search in Google Scholar

9. Tsakiridis, I, Mamopoulos, A, Athanasiadis, A, Kourtis, A, Dagklis, T. Management of pregestational diabetes mellitus: a comparison of guidelines. J Matern Fetal Neonatal Med 2020:1–10. https://doi.org/10.1080/14767058.2020.1719481.Search in Google Scholar

10. Palmer, KT, Bonzini, M, Harris, EC, Linaker, C, Bonde, JP. Work activities and risk of prematurity, low birth weight and pre-eclampsia: an updated review with meta-analysis. Occup Environ Med 2013;70:213–22. https://doi.org/10.1136/oemed-2012-101032.Search in Google Scholar

11. Davies, GAL, Wolfe, LA, Mottola, MF, MacKinnon, C. No. 129-exercise in pregnancy and the postpartum period. J Obstet Gynaecol Can 2018;40:e58–5. https://doi.org/10.1016/j.jogc.2017.11.001.Search in Google Scholar

12. Global recommendations on physical activity for Health. WHO, editor 2010.Search in Google Scholar

13. WHO. World Health Organization. Global recommendations on physical activity for health.Search in Google Scholar

14. Clapp, JF3rd, Lopez, B, Harcar-Sevcik, R. Neonatal behavioral profile of the offspring of women who continued to exercise regularly throughout pregnancy. Am J Obstet Gynecol 1999;180:91–4. https://doi.org/10.1016/s0002-9378(99)70155-9.Search in Google Scholar

15. Clapp, JF3rd, Simonian, S, Lopez, B, Appleby-Wineberg, S, Harcar-Sevcik, R. The one-year morphometric and neurodevelopmental outcome of the offspring of women who continued to exercise regularly throughout pregnancy. Am J Obstet Gynecol 1998;178:594–9. https://doi.org/10.1016/s0002-9378(99)70155-9.Search in Google Scholar

16. Persinger, R, Foster, C, Gibson, M, Fater, DC, Porcari, JP. Consistency of the talk test for exercise prescription. Med Sci Sports Exerc 2004;36:1632–6.Search in Google Scholar

17. Avery, ND, Wolfe, LA, Amara, CE, Davies, GA, McGrath, MJ. Effects of human pregnancy on cardiac autonomic function above and below the ventilatory threshold. J Appl Physiol (1985) 2001;90:321–8. https://doi.org/10.1152/jappl.2001.90.1.321.Search in Google Scholar

18. Wolfe, LA. PARmed-X for pregnancy: canadian society for exercise Pphysiology, Ottawa 2002 [Available from: .Search in Google Scholar

19. Borg, GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982;14:377–81. https://doi.org/10.5271/sjweh.1815.Search in Google Scholar

20. Szymanski, LM, Satin, AJ. Strenuous exercise during pregnancy: is there a limit? Am J Obstet Gynecol 2012;207:179 e1–6. https://doi.org/10.1016/j.ajog.2012.07.021.Search in Google Scholar

21. Runge, SB, Pedersen, JK, Svendsen, SW, Juhl, M, Bonde, JP, Nybo Andersen, AM. Occupational lifting of heavy loads and preterm birth: a study within the Danish National Birth Cohort. Occup Environ Med 2013;70:782–8. https://doi.org/10.1136/oemed-2012-101173.Search in Google Scholar

22. Artal, R, Catanzaro, RB, Gavard, JA, Mostello, DJ, Friganza, JC. A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus. Appl Physiol Nutr Metab 2007;32:596–1. https://doi.org/10.1139/h07-024.Search in Google Scholar

23. Milunsky, A, Ulcickas, M, Rothman, KJ, Willett, W, Jick, SS, Jick, H. Maternal heat exposure and neural tube defects. JAMA 1992;268:882–5. https://doi.org/10.1001/jama.1992.03490070064043.Search in Google Scholar

24. Ravanelli, N, Casasola, W, English, T, Edwards, KM, Jay, O. Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis. Br J Sports Med 2019;53:799–805. https://doi.org/10.1136/bjsports-2017-097914.Search in Google Scholar

25. Morkved, S, Bo, K. Effect of postpartum pelvic floor muscle training in prevention and treatment of urinary incontinence: a one-year follow up. Bjog 2000;107:1022–8. https://doi.org/10.1111/j.1471-0528.2000.tb10407.x.Search in Google Scholar

26. Thubert, T, Bakker, E, Fritel, X. Pelvic floor muscle training and pelvic floor disorders in women. Gynecol Obstet Fertil 2015;43:389–394. https://doi.org/10.1016/j.gyobfe.2015.03.026.Search in Google Scholar

27. McCurdy, AP, Boule, NG, Sivak, A, Davenport, MH. Effects of exercise on mild-to-moderate depressive symptoms in the postpartum period: a meta-analysis. Obstet Gynecol 2017;129:1087–97. https://doi.org/10.1097/aog.0000000000002053.Search in Google Scholar

28. Koltyn, KF, Schultes, SS. Psychological effects of an aerobic exercise session and a rest session following pregnancy. J Sports Med Phys Fitness 1997;37:287–91.Search in Google Scholar

29. Bane, SM. Postpartum exercise and lactation. Clin Obstet Gynecol 2015;58:885–92. https://doi.org/10.1097/GRF.0000000000000143.Search in Google Scholar

30. Cary, GB, Quinn, TJ. Exercise and lactation: are they compatible? Can J Appl Physiol 2001;26:55–75. https://doi.org/10.1139/h01-004.Search in Google Scholar

Received: 2019-11-13
Accepted: 2020-04-27
Published Online: 2020-07-03
Published in Print: 2020-07-28

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