Recommendations for physical activity for pregnant women
Abstract
Properly selected and prescribed physical activity during pregnancy has a favorable effects on the health of pregnant women and the fetus, and is excellent preparation for childbirth. Absolute and relative contraindications to exercise during pregnancy are well defined, as well as the warning signs to terminate exercise while pregnant. Knowledge of these is essential for physically active pregnant women and exercise professionals that work with pregnant women. Pregnant women should be moderately physically active every day of the week for at least 30 minutes. The term moderate is thoroughly and clearly defined in the guidelines. Resistance exercises during pregnancy are safe but it is advised to use light loads and a large number of repetitions (e.g. 15-20 repetitions). Strength exercises for the pelvic floor muscles deserves a special place during pregnancy. Appropriate forms of physical activity for pregnant women are walking and jogging, swimming and aquatic exercise, cycling, Pilates and yoga, aerobics, fitness and cross-country skiing. Certain forms of physical activity need special adjustments (alpine skiing, ice skating and rollerblading, racket sports, team ball games, horseback riding and scuba diving).
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References
Sports Medicine Australia (SMA). Exercise in Pregnancy [Internet]. 2014 [cited 2014 Feb 17]. p. 4. Available from: http://sma.org.au/wp-content/uploads/2009/10/WIS-ExPreg.pdf
Brown W. The benefits of physical activity during pregnancy. J Sci Med Sport. 2002;5:37–45.
Nascimento SL, Surita FG, Cecatti JG. Physical exercise during pregnancy: a systematic review. Curr Opin Obstet Gynecol. 2012;24:387–94.
Association of Chartered Physiotherapists in Women’s Health (ACPWH). Fit and safe to exercise in the childbearing year. ACPWH, editor. London; 2013. p. 24.
Melzer K, Schutz Y, Boulvain M, Kayser B. Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Med. 2010 Jun 1;40(6):493–507.
American College of Obstetricians and Gynecologists (ACOG). Exercise during pregnancy and the postpartum period: ACOG Committee Opinion No. 267 (reaffirmed 2009). Obstet Gynecol. 2002;99:171–3.
Podlesnik Fetih A, Videmsek M, Vrtacnik-Bokal E, Globevnik Velikonja V, Karpljuk D, Pajntar M, et al. Sportna dejavnost, prehrana, razvade in psihicno pocutje nosecnice. Ljubljana: Fakulteta za sport, Institut za kineziologijo; 2010.
Hegaard HK, Damm P, Hedegaard M, Henriksen TB, Ottesen B, Dykes A-K, et al. Sports and leisure time physical activity during pregnancy in nulliparous women. Matern Child Health J. 2011;15:806–13.
Stafne SN, Salvesen KÅ, Romundstad PR, Stuge B, Mørkved S. Does regular exercise during pregnancy influence lumbopelvic pain? A randomized controlled trial. Acta Obstet Gynecol Scand. 2012;91:552–9.
Pennick V, Liddle SD. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane database Syst Rev. 2013;8.
Boissonnault JS, Pearcy K, Klestinski JU. The role of exercise in the
management of pelvic girdle and low back pain in pregnancy: A systematic review of the literature. J Women’s Heal Phys Ther J Women's Heal Phys Ther. 2012;36(2):69–77.
Dempsey JC, Butler CL, Williams MA. No need for a pregnant pause: physical activity may reduce the occurrence of gestational diabetes mellitus and preeclampsia. Exerc Sport Sci Rev. 2005;33:141–9.
Pivarnik, JM, Chambliss, HO, Clapp, JF. Impact of physical activity during pregnancy and postpartum on chronic disease risk. Med Sci Sports Exerc. 2006;38:989–1006.
Campbell MK, Mottola MF. Recreational exercise and occupational activity during pregnancy and birth weight: a case-control study. Am J Obstet Gynecol. 2001;184:403–8.
Mihevc P, Šćepanović D. Telesna dejavnost in njen vpliv na zmanjšanje pojava nevšečnosti v nosečnosti: pregled literature. Univerza v Ljubljani, Zdravstvena fakulteta; 2011. p. 52.
Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med. 2013;1–13.
UK Midwifery Archives. Horse-riding and the Pelvic Floor in Birth [Internet]. 2014 [cited 2014 Feb 17]. Available from: http://www.midwifery.org.uk/?page_id=713
Baby Centre. Your pelvic floor in pregnancy - BabyCentre [Internet]. 2014 [cited 2014 Feb 13]. Available from: http://www.babycentre.co.uk/a536339/your-pelvic-floor-in-pregnancy
Nielsen CA, Sigsgaard I, Olsen M, Tolstrup M, Danneskiold-Samsoee B, Bock JE. Trainability of the pelvic floor. A prospective study during pregnancy and after delivery. Acta Obstet Gynecol Scand. 1988;67:437–40.
Dias L a R, Driusso P, Aita DLCC, Quintana SM, Bø K, Ferreira CHJ. Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial. Rev Bras Fisioter. 2011;15:487–93.
Salvesen KA, Mørkved S. Randomised controlled trial of pelvic floor muscle training during pregnancy. BMJ. 2004 Aug 14;329(7462):378–80.
Gamberger Z, Videmšek M, Karpljuk D. Trening mišic medeničnega dna. Šport. 2005;53(4):29–32.
Bung P. Schwangerschaft und Sport. Gynakologe. 1999. p. 386.
Podlesnik Fetih A, Videmsek M, Globevnik Velikonja V, Vrtacnik-Bokal E, Karpljuk D. The state of mind of less physical active and regularly physically active women in the second trimester of their pregnancies. Acta Univ Palacki Olomuc Gymnica. 2008;38(3):37–44.
Gaston A, Cramp A. Exercise during pregnancy: a review of patterns and determinants. J Sci Med Sport. 2011;14:299–305.
Wojtyła A. Application of the hypothesis of Developmental Origin of Health and Diseases (DOHaD) in epidemiological studies of women at reproductive age and pregnant women in Poland. Ann Agric Environ Med. 2011;18:355–64.
American college of sports medicine (ACSM). ACSM’s guidelines for exercise testing and prescription / American College of Sports Medicine ; senior editor, ; associate editors, . - Version details - Trove. 8th ed. Thompson WR, Gordon NF, Pescatello LS, editors. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010. p. 380.
DiFranza JR, Aligne CA, Weitzman M. Prenatal and postnatal environmental tobacco smoke exposure and children’s health. Pediatrics. 2004;113:1007–15.
British Medical Association (BMA). Smoking and reproductive life. The impact of smoking on sexual, reproductive and child health. London: British Medical Association Board of Science and Education & T obacco Control Resource Centre; 2004. p. 66.
Owe KM, Nystad W, Skjaerven R, Stigum H, Bø K. Exercise during Pregnancy and the Gestational Age Distribution: A Cohort Study. Med Sci Sports Exerc. 2012;44:1067–74.
Borodulin KM, Evenson KR, Wen F, Herring AH, Benson AM. Physical activity patterns during pregnancy. Med Sci Sports Exerc. 2008;40:1901–8.
Smith KM, Foster RC, Campbell CG. Accuracy of physical activity assessment during pregnancy: an observational study. BMC Pregnancy Childbirth. 2011 Jan;11:86.
Haakstad LAH, Bø K. Effect of regular exercise on prevention of excessive weight gain in pregnancy: a randomised controlled trial. Eur J Contracept Reprod Health Care. 2011;16:116–25.
Ferraro ZM, Gaudet L, Adamo KB. The potential impact of physical activity during pregnancy on maternal and neonatal outcomes. Obstet Gynecol Surv. 2012 Feb;67(2):99–110.
Clapp JF. The effects of maternal exercise on fetal oxygenation and feto-placental growth. Eur J Obstet Gynecol Reprod Biol. 2003 Sep;110:S80–S85.
Leiferman JA, Evenson KR. The effect of regular leisure physical activity on birth outcomes. Matern Child Health J. 2003;7:59–64.
Cannella D, Lobel M, Monheit A. Knowing is believing: information and attitudes towards physical activity during pregnancy. J Psychosom Obstet Gynaecol. 2010 Dec;31(4):236–42.
Royal College of Obstetrics and Gynaecology. Statement No. 4. Exercise in Pregnancy. London: RCOG; 2006. p. 7.
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:377–81.
Zavorsky GS, Longo LD. Exercise guidelines in pregnancy: new perspectives. Sports Med. 2011;41:345–60.
Avery ND, Stocking KD, Tranmer JE, Davies GA, Wolfe LA. Fetal responses to maternal strength conditioning exercises in late gestation. Can J Appl Physiol. 1999;24:362–76.
Treuth MS, Butte NF, Puyau M. Pregnancy-Related Changes in Physical Activity, Fitness, and Strength. Med Sci Sport Exerc. 2005 May;37(5):832–7.
Stephenson RG, O’Connor LJ. Obstetric and Gynecologic Care in Physical Therapy [Paperback]. Second Edi. Thorofare, NJ: Slack Incorporated; 2000. p. 352.
Šćepanović D. Telesna dejavnost v nosecnosti = Physical activity during preganancy. Vloga gibalne, Sport Akt pri preprecevanju nastanka Bolezn Zdr. Ljubljana: Zavod FIT; 2010. p. 1–7.
Ashton-Miller JA, DeLancey JOL. Functional anatomy of the female pelvic floor. In: Bø K, Berghmans B, Mørkved S, Van Kampen M, editors. Evidence-Based Phys Ther Pelvic Floor. Philadelphia: Churchill Livingstone Elsevier; 2007. p. 19–33.
Pauleta JR, Pereira NM, Graça LM. Sexuality during pregnancy. J Sex Med. 2010;7:136–42.
Hay-Smith J, Mørkved S, Fairbrother KA, Herbison GP. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane database Syst Rev. 2008 Jan;(4):CD007471.
National Institute for Health and Clinical Excellence (Great Britain). Urinary incontinence : the management of urinary incontinence in women : quick reference guide. London: National Institute for Health and Clinical Excellence; 2006.
Bø K. Pelvic floor muscle exercise for the treatment of stress urinary incontinence: An exercise physiology perspective. Int Urogynecol J. 1995 Sep;6(5):282–91.
Davies GAL, Wolfe LA, Mottola MF, MacKinnon C. Joint SOGC/CSEP clinical practice guideline: exercise in pregnancy and the postpartum period. Can J Appl Physiol. 2003 Jun;28(3):330–41.
Mlakar KK, Videmsek M, Vrtacnik-Bokal E, Zgur L, Scepanovic D, Martincic B, et al. Z gibanjem v zdravo nosečnost. Ljubljana: Fakulteta za sport; 2011. p. 58.
Katz VL, McMurray R, Goodwin WE, Cefalo RC. Nonweightbearing exercise during pregnancy on land and during immersion: a comparative study. Am J Perinatol. 1990 Jul;7(3):281–4.
Waller B, Lambeck J, Daly D. Therapeutic aquatic exercise in the treatment of low back pain: a systematic review. Clin Rehabil. 2009 Jan;23(1):3–14.
Smith SA, Michel Y. A pilot study on the effects of aquatic exercises on discomforts of pregnancy. J Obstet Gynecol Neonatal Nurs. 2006;35(3):315–23.
Katz VL, McMurray R, Berry MJ, Cefalo RC. Fetal and uterine responses to immersion and exercise. Obstet Gynecol. 1988;72:225–30.
Katz VL, Mc Murray RG, Cefalo RC. Exercise in pregnancy. In: Artal R, Mittelmark RA, Wiswell RA, editors. Aquat Exerc Dur pregnancy. 2 Sub edit. Philadelphia: Williams & Wilkins; 1991. p. 271–8.
O’Neill ME, Cooper KA, Boyce ES, Hunyor SN. Postural effects when cycling in late pregnancy. Women Birth. 2006 Dec;19(4):107–11.
King M, Green Y. Pilates Workbook for Pregnancy: Illustrated Step-by-Step Matwork Techniques. London: Ulysses Press; 2002. p. 96.
Selby A. Pilates for pregnancy : gentle and effective techniques, for before and after birth. London: Thorsons; 2002.
Pravilnik o zagotavljanju varnosti in zdravja pri ročnem premeščanju bremen. Ur List Republike Slov. 2005;(73):7789.
Heffernan AE. Exercise and pregnancy in primary care. Nurse Pract. 2000 Mar;25(3):42, 49, 53–6 passim.
Arena B, Maffulli N. Exercise in Pregnancy: How Safe Is It? Sports Med Arthrosc. 2002 Mar;10(1):15–22
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