Risk assessment for physical activity and exercise clearance: in pregnant women without contraindications (original) (raw)
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Physical activity throughout pregnancy: guideline critical appraisal and implementation tool
PubMed, 2021
Objective: The 2019 Canadian guideline for physical activity throughout pregnancy provides evidencebased recommendations to promote maternal, fetal, and neonatal health. We aimed to 1) critically appraise the 2019 Canadian guideline for physical activity throughout pregnancy; and 2) develop a guideline summary for clinicians to facilitate the uptake of recommendations into practice. Methods: We used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to critically appraise the quality and reporting of this guideline. Four reviewers independently scored between 1 (strongly disagree) to 7 (strongly agree) for 23 items organized into six quality domains. Results: AGREE II quality domain scores ranged from 47%-64% and the overall quality of the guideline was rated as 83% (high quality). Conclusion: Based on its methodological quality, we recommend the use of this guideline. Our guideline summary includes six recommendations and other safety precautions that are relevant for clinicians in Canada.
Physical Activity Assessment During Gestation and Its Outcomes: A Review
Background: Physical activity recommendations emphasize a positive influence of exercise on health. It is particularly recognized during pregnancy for both the mother and fetus. Aim: This review aims to identify the main trends of activity undertaken by women during gestation and to find out how it affects the expecting mother and her child. Methods: Review of the literature comprising the following databases: PubMed, Academic Search Complete, Health Source—Consumer Edition, Health Source: Nursing/Academic Edition, EMBASE (2000 to May 2013), used detailed search strategies. The review was restricted to experimental studies. Trials were excluded if they met any of the following criteria: reviews, letters, commentaries or editorials, only abstracts available, and any kind of pathology during pregnancy. Three assessors reviewed the titles, abstracts, and full articles using standardized data abstraction forms, and they assessed the study quality. A total of 474 potential articles remained for analyses. Findings: Twenty-eight articles were eligible for inclusion in the present review: randomized controlled trials and observational studies that evaluated maternal and offspring outcomes as a result of physical activity during pregnancy. Quasi-randomized trials were excluded. The activities that were most frequently assessed included occupational activity, housework/caregiving, sport/exercise, and active living, as well as habits. The authors evaluated different types of physical activity in the loading conditions. The aerobic activities most frequently used for assessment included treadmill walking program; step aerobics or stair stepper; aerobics; bicycle ergometer; combination of rowing, stationary cycling, and walk jogging; rhythmic calisthenics class and step class; brisk walks; stretching; and relaxation. The benefits following being active during pregnancy are associated with improved maternal psychological well-being, a reduced risk of preterm birth and excessive gestational weight gain, and lower risk of birth-related complications. Conclusions: Patterns of activity change during pregnancy. Although exercise is safe for both the mother and fetus, most women reduce their activity level during the first weeks of gestation. Specifically, physical activity tends to be of lower duration, frequency, and intensity. Therefore, women should be encouraged by professionals to initiate or continue exercising during a healthy pregnancy. Target Audience: Obstetricians and gynecologists, family physicians. Learning Objectives: After completing this activity, the learner should be better able to identify the main trends among pregnant women in terms of physical activity, investigate the main benefits following exercising during pregnancy, recognize the most popular forms of physical activity in pregnant population, and realize health professionals to make women more aware of the importance of exercise.
Patterns of physical activity across pregnancy and adverse pregnancy outcomes
Caspian Journal of Reproductive Medicine, 2018
Background: This study aimed to identify patterns of physical activity in pregnancy contributions to the development of adverse pregnancy outcomes. Methods: In a prospective study, physical activity of 374 pregnant women was measured using Pregnancy Physical Activity Questionnaire (PPAQ) during the first half and the second half of pregnancy. Pregnancy outcomes were recorded as birth weight, preterm delivery, hypertension without proteinuria, preeclampsia, mode of delivery, and gestational diabetes. Results: There was a significant decrease in values of self-reported physical activity from the first half of pregnancy to the second half of pregnancy in light (P <0.001), moderate (P <0.001), vigorous (P= 0.029), total (P <0.001) intensity. The women with the highest tertile of total physical activity in the first half of pregnancy had significantly lower adjusted odds (OR: 0.07, 95% CI: 0.02-0.32) of having a macrosomia newborn and higher adjusted odds (OR: 6.44, 95% CI: 1.38-30.14) of having a low birth weight infant. The risks of cesarean section for women in the highest category of total physical activity in the second half of pregnancy was higher those in the lower and lowest category (OR: 1.89, 95% CI: 0.29-3.36). Conclusion: It is necessary to emphasis on physical activity guideline for reduction of pregnancy complications.
Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women
Revista Brasileira de Ginecologia e ObstetrÃcia / RBGO Gynecology and Obstetrics, 2022
Objective To assess the levels of physical activity and exercise practice, and examine the associated maternal characteristics; as well as the anxiety levels of high-risk pregnant women. Methods A cross-sectional study conducted with pregnant women at a High-risk Prenatal Clinic (HRPC) in a tertiary maternity. Pregnant women of 18 to 40-years-old, with a single fetus, and with gestational age up to 38 weeks were included. The level of physical activity and exercise practice of the study's participants were investigated using the Pregnancy Physical Activity Questionnaire (PPAQ). Maternal sociodemographic, anthropometric, and medical data were investigated using a specific form. For anxiety levels, the short version of the State-Trait Anxiety Inventory (STAI) was applied. We used the Student t-test, chi-square test, odds ratio (OR) with 95% confidence interval (95% CI) and multiple logistic regression. The significance level was 5%. Results Among the 109 pregnant women included, 8...
Student's Journal of Health Research Africa, 2022
Background: Physical activity during pregnancy provides many health benefits not only to pregnant mothers but also to the fetuses. Adequate knowledge among pregnant mothers is vital to enhance positive attitudes. This study assessed knowledge of pregnant women on PA in pregnancy among pregnant women attending ANC in Lira Regional Referral Hospital. Methods: The cross-sectional study of 152 pregnant women attending antenatal clinic visits in Lira Regional referral Hospital, northern Uganda. Data were obtained on socio-demographic characteristics of mothers, knowledge,and attitude towards PA in pregnancy. Results: Decreasing the risk of swelling of extremities (65%), back pain (73%), and high blood pressure (80%), and promoting better ability to cope with labor and delivery (72%) were the most commonly known benefits of PA in pregnancy and vaginal bleeding (80%), chest pain (70%), difficulty in breathing (77%), abdominal pain (72%), premature labor (73%), muscle physical activity during pregnancy. 46% had adequate overall knowledge of PA weakness and migraine headache (73%) were perceived contraindications of during pregnancy. The knowledge of women was influenced by gestational age (p=0.007) and level of education (p=0.014). Conclusion: The majority of women demonstrated inadequate knowledge of physical activity during pregnancy. Mothers had a fair knowledge of the benefit, but the majority had minimal information about the contraindication and when to start and stop physical activity when they get pregnant. Recommendation: Based on the findings, women in this study didn't have comprehensive knowledge about PA during pregnancy, health care providers should be empowered to counsel healthy and fit pregnant women with a comprehensive, evidence-based prenatal exercise guidelines on the safety of involvement in PA during pregnancy.
Physical activity and exercise during pregnancy
European Journal of Physiotherapy, 2014
"A physical inactive lifestyle is associated with increased prevalence of chronic diseases such as cardiovascular disease, type 2 diabetes, osteoporosis and cancer. The proportion of pregnant women with overweight or obesity is increasing rapidly across the world and this excess weight, mainly obesity, is associated with increased risk of health problems during pregnancy and in connection with childbirth. Pregnancy poses significant physiological changes in the body and thus many pregnant women are worried about being physically active or exercising during this period. This literature review aimed to determine the advantages or disadvantages, current recommendations and restrictions on physical activity and exercise during normal pregnancy. Searches were carried out on databases PubMed, CINHAL and the Cochrane Library. The review indicates that all healthy pregnant women can be physically active to achieve health benefits. Physical activity and exercise during pregnancy does not increase any risk of adverse pregnancy or birth outcomes, not even for elite athlete women. All healthy pregnant women can remain physically active. However, high-risk sports or hard working should be avoided; greater caution and carefulness should be taken to avoid any unexpected complications and elite knowledge about physical activity and exercise during normal pregnancy is necessary. "
Physical Activity and Pregnancy: Past and Present Evidence and Future Recommendations
Research Quarterly for Exercise and Sport, 2012
Purpose-This review provides researchers and practitioners with an overview of the physical activity and pregnancy literature to promote prenatal physical activity, improve measurement, further elucidate the role of activity in reducing maternal health complications, and inform future research. Methods-We examined past and present physical activity and pregnancy studies and highlight key papers with a particular focus on maternal health outcomes to best inform physical activity promotion efforts. Results-This review discusses: (a) historical overview of prenatal physical activity with a specific focus on the physical activity guidelines, how they have changed over time, and how evidence of the effect of prenatal activity on maternal/fetal health outcomes has impacted clinical recommendations; (b) existing tools and challenges associated with measuring prenatal physical activity; (c) empirical evidence on the multi-level determinants of prenatal activity to help guide future intervention work; (d) empirical evidence of prenatal activity on adverse maternal outcomes (gestational diabetes mellitus, preeclampsia, excessive gestational weight gain) from observational and intervention studies; and (e) summary/recommendations for future research and practice. Conclusions-The physical activity and pregnancy literature has evolved over the past 50 years and there is currently sufficient empirical evidence to support the promotion of moderate to vigorous prenatal physical activity for maternal health benefits. Future studies and interventions should be carefully-designed, theoretically driven, and include validated and reliable measures of activity. Researchers and practitioners should also consider the multifaceted determinants and outcomes of prenatal physical activity and intervening to promote physical activity before, during, and after pregnancy.
Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World
American journal of lifestyle medicine, 2014
Women attain numerous benefits from physical activity during pregnancy. However, due to physical changes that occur during pregnancy, special precautions are also needed. This review summarizes current guidelines for physical activity among pregnant women worldwide. We searched PubMed (MedLINE) for country-specific governmental and clinical guidelines on physical activity during pregnancy through the year 2012. We cross-referenced with articles referring to guidelines, with only the most recent included. An abstraction form was used to extract key details and summarize. In total, 11 guidelines were identified from nine countries (Australia, Canada, Denmark, France, Japan, Norway, Spain, United Kingdom, United States). Most guidelines supported moderate intensity physical activity during pregnancy (10/11) and indicated specific frequency (9/11) and duration/time (9/11) recommendations. Most guidelines provided advice on initiating an exercise program during pregnancy (10/11). Six gui...
Background: Preterm birth is associated with most cases of neonatal deaths and negative health outcomes, and hypertensive disorders. Hypertension is influenced by maternal behavior, such as physical activity. Physical activity is associated with better outcomes for mother and fetus, besides healthier weight gains during pregnancy. Few women are physically active during pregnancy and few clinical trials have been carried out with pregnant women. The aim of this paper is to describe the protocol of a controlled trial evaluating whether regular exercise during pregnancy may result in improved maternal-child health and neonatal outcomes. Methods/Design: The PAMELA (Physical Activity for Mothers Enrolled in Longitudinal Analysis) trial is a randomized controlled trial nested in a birth cohort study. Eligible women belonging to the birth cohort will be invited (between the 16th and 20th week of gestation) to enroll in the trial. Baseline data (blood and urine samples, anthropometry and pulmonary function) will be collected at enrollment. The same assessments will be repeated eight and 16 weeks after baseline. After randomization, women will be allocated into either one of these groups: control, 426 women who will be advised to keep their usual daily activities; and intervention, 213 women who will engage in an exercise program, three sessions a week. At least 70 % attendance over 16 weeks will be required to be considered compliant to the intervention. Exercise protocol will include aerobics, strength and flexibility training. Maternal and child outcomes will be measured at the 36th week of gestation, at birth and at three, 12, 24 and 48 months postpartum. An intention-to-treat analysis will be performed.