Exercise in Pregnancy and the Postpartum Period

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Abstract

Objective:To design Canadian guidelines advising obstetric care providers of the maternal, fetal, and neonatal implications of aerobic and strength-conditioning exercises in pregnancy.

Outcomes:Knowledge of the impact of exercise on maternal, fetal, and neonatal morbidity, and of the maternal measures of fitness.

Evidence:MEDLINE search from 1966 to 2002 for English-language articles related to studies of maternal aerobic and strength conditioning in a previously sedentary population, maternal aerobic and strength conditioning in a previously active population, impact of aerobic and strength conditioning on early and late pregnancy outcomes, and impact of aerobic and strength conditioning on neonatal outcomes, as well as for review articles and meta-analyses related to exercise in pregnancy.

Values:The evidence collected was reviewed by the Society of Obstetricians and Gynaecologists of Canada (SOGC Clinical Practice Obstetrics Committee) with representation from the Canadian Society for Exercise Physiology, and quantified using the evaluation of evidence guidelines developed by the Canadian Task Force on the Periodic Health Exam.

Recommendations:

  • 1.

    All women without contraindications should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy. (II-I,2B)

  • 2.

    Reasonable goals of aerobic conditioning in pregnancy should be to maintain a good fitness level throughout pregnancy without trying to reach peak fitness or train for an athletic competition. (II-1,2C)

  • 3.

    Women should choose activities that will minimize the risk of loss of balance and fetal trauma. (Ill-C)

  • 4.

    Women should be advised that adverse pregnancy or neonatal outcomes are not increased for exercising women. (II-I,2B)

  • 5.

    Initiation of pelvic floor exercises in the immediate postpartum period may reduce the risk of future urinary incontinence. (II-1C)

  • 6.

    Women should be advised that moderate exercise during lactation does not affect the quantity or composition of breast milk or impact infant growth. (I-A)

Validation:This guideline has been approved by the SOGC Clinical Practice Obstetrics Committee, the Executive and Council of SOGC, and the Board of Directors of the Canadian Society for Exercise Physiology.

Sponsors:This guideline has been jointly sponsored by the Society of Obstetricians and Gynaecologists of Canada and the Canadian Society for Exercise Physiology.

References (62)

  • JF Clapp

    The changing thermal response to endurance exercise during pregnancy

    Am J Obstet Gynecol

    (1991)
  • AP Heenan et al.

    Maximal exercise testing in late gestation: maternal responses

    Obstet Gynecol

    (2001)
  • A MacPhail et al.

    Maximal exercise testing in late gestation: fetal responses

    Obstet Gynecol

    (2000)
  • EM Camporesi

    Diving and pregnancy

    Semin Perinatol

    (1996)
  • R Huch

    Physical activity at altitude in pregnancy

    Semin Perinatol

    (1996)
  • CA Lovelady et al.

    Lactation performance of exercising women

    Am J Clin Nutr

    (1990)
  • CM Sampselle et al.

    Physical activity and postpartum well-being

    J Obstet Gynecol Neonatal Nurs

    (1999)
  • Handbook for physical activity guide to healthy active living. [Également disponible en français sous le titre Cahier...

  • Exercise during pregnancy and the postnatal period

    (1985)
  • MM Shangold

    Exercise during pregnancy: current state of the art

    Can Fam Physician

    (1989)
  • N Tarfari et al.

    Effects of maternal undernutrition and heavy physical work during pregnancy on birth weight

    Br J Obstet Gynaecol

    (1980)
  • M Terada

    Effect of physical activity before pregnancy on fetuses of mice exercised forcibly during pregnancy

    Teratology

    (1974)
  • MC Hatch et al.

    Maternal exercise during pregnancy, physical fitness, and fetal growth

    Am J Epidemiol

    (1993)
  • B Sternfeld et al.

    Exercise during pregnancy and pregnancy outcome

    Med Sci Sports Exerc

    (1995)
  • ME O’Neill

    Maternal rectal temperature and fetal heart rate responses to upright cycling in late pregnancy

    Br J Sports Med

    (1996)
  • LA Wolfe et al.

    Validation of guidelines for aerobic exercise in pregnancy

  • SH Woolf et al.
  • IKM Brenner et al.

    Physical conditioning effects on fetal heart rate responses to graded maternal exercise

    Med Sci Sports Exerc

    (1999)
  • PJ Ohtake et al.

    Physical conditioning attenuates respiratory responses to steady-state exercise in late gestation

    Med Sci Sports Exerc

    (1998)
  • LA Wolfe et al.

    Prescription of aerobic exercise during pregnancy

    Sports Med

    (1989)
  • EA Lokey et al.

    Effects of physical exercise on pregnancy outcomes: a meta-analytic review

    Med Sci Sports Exerc

    (1991)

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