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PregencyAndExercise

Pregnancy & Exercise

Exercise/physical activity (PA) & pregnancy

Evidence based recommendations from: Perales et al. (2017) (1)

Exercise during pregnancy:

Table. Exercise Recommendations and Precautions for Pregnant Women

Type of program

Duration/frequency 

Optimal intensity 

To be avoided 

Low-impact aerobic exercise

Walking, aerobic dancing, stationary
cycling, jogging (in previously active
women), or swimming

20-30 min,
3-5 d/wk

Moderate as ideally controlled via heart
rate (≤80% HRmax), rate of perceived
exertion (ie, 13-14 on the Borg scale),
or the more practical talk test

High-intensity (>90% HRmax) strenuous exercise;
long-distance running; exercises with risk of falls
or impact of the body against the ground or hard
surfaces (jumping or quick changes of direction),
or physiological danger (eg, diving)

Strength exercise (toning)

Resistance bands, dumbbells, body weight
exercises involving large muscles

15-20 min,
3-5 d/wk

Light to moderate loads (eg, 1-2 sets
of 10-15 repetitions using 1- to 3-kg
dumbbells)

Isometric exercises, Valsalva maneuver, frequent
heavy weight lifting, hot yoga or pilates, supine
position exercises

Pelvic floor muscle training (Kegel) 

10-15 min,

3-5 d/wk

≈ 100 Repetitions

Combination of the low-impact aerobic and
strength exercises (highly recommended)

Low-impact aerobic and strength
exercises combined (eg, aerobic dancing
followed by use of dumbbells)

45-65 min,
3-4 d/wk

Same as for low-impact aerobic
and strength exercises

Same as for low-impact aerobic
and strength exercises

Pregnancy and Risk of Gestational Diabetes Mellitus

Evidence based recommendations from: Tobias et al. (2011) (2)

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with increased risk of negative health outcomes for both mothers and their children.

“Higher levels of physical activity (PA) before pregnancy or in early pregnancy are associated with a significantly lower risk of developing GDM.”

“Women with GDM have an increased risk for perinatal morbidity and impaired glucose tolerance and type 2 diabetes in the years after pregnancy.”

“Children of women with GDM are more likely to be obese and have impaired glucose tolerance and diabetes in childhood and early adulthood.”

  •  PA & improving glucose homeostasis.
  •  PA & improved insulin sensitivity 

The magnitude of this association was greatest for pre pregnancy physical activity with women in the highest quantiles of activity experiencing a 55% reduction in risk, compared with that for women with the lowest activity.

Guidelines for Physical Activity during Pregnancy

Evidence based recommendations from: Evenson et al. (2014) (3)

  • World Health Organization’s guideline on physical activity recommends that adults age 18 to 64 years should engage in at least 150 minutes of moderate intensity aerobic activity throughout the week (in bouts of at least 10 minutes), or at least 75 minutes of vigorous intensity aerobic activity, or an equivalent combination of the two. The guideline states that pregnant women may need extra precaution and should seek medical advice before striving to achieve the recommendations.
  • Contraindications to exercise including anemia, persistent bleeding, cardiovascular disease, cerclage or incompetent cervix, multiple gestation, preeclampsia or pregnancy induced hypertension, premature contractions or labor, premature rupture of membranes, and thyroid disease.
  • Avoid excessive body heat during exercise for pregnant women.
  • (Start PA even if previously physically inactive)

Canadian guideline stated that for uncomplicated pregnancies “women with or without a previously sedentary lifestyle should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle”

  • Frequency: Canada and the United Kingdom indicated a minimum of 15 minute sessions for 3 times per week, progressing to 30 minutes, 4 times per week even if intensity was reduced.
  • Intensity: The target heart rate zones provided by Canada represented 60% to 80% of maximal aerobic capacity.
  • Warm up & cool down recommended, also adequate hydration during exercise.

Clarifying some definitions:

Physical activity is a broad term that is defined as any bodily movement produced by contraction of skeletal muscles that results in increased energy expenditure above a basal level. 

Exercise is a subcategory of physical activity that is planned, structured, and purposive to maintain or improve one or more components of physical fitness.

Top pregnancy exercise myths debunked (video):

https://youtu.be/jWIk6h_1cbI 

Reference list:

  1. Perales M, Artal R, Lucia A. Exercise during pregnancy. Jama. 2017 Mar 21;317(11):1113-4.
  2. Tobias DK, Zhang C, Van Dam RM, Bowers K, Hu FB. Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes care. 2011 Jan 1;34(1):223-9.
  3. Evenson KR, Barakat R, Brown WJ, Dargent-Molina P, Haruna M, Mikkelsen EM, et al. Guidelines for Physical Activity During Pregnancy: Comparisons From Around the World. American Journal of Lifestyle Medicine [Internet]. 2014 Mar 1 [cited 2022 Jun 7];8(2):102–21. Available from: https://pubmed.ncbi.nlm.nih.gov/25346651/

Credit: 

Image: Alex Coppel

Article: Herald Sun

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