Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC expert group meeting, Lausanne. Part 4—Recommendations for future research

Bø, Kari; Artal, Raúl; Barakat, Rubén; Brown, Wendy J.; Davies, Gregory; Dooley, Mike; Evenson, Kelly R.; Haakstad, Lene Annette Hagen; Kayser, Bengt; Kinnunen, Tarja I.; Larsén, Karin; Mottola, Michelle F.; Nygaard, Ingrid; Poppel, Mireille van; Stuge, Britt; Khan, Karim M.

doi:10.1136/bjsports-2017-098387

Cited by 39 publications

(20 citation statements)

References 6 publications

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“…Perineal tears not influencing returning to running may be explained by the median time to return-to-running being 12-weeks. Encouragingly, this median timeframe aligns with clinical guidelines 11 and IOC consensus recommendations 37 and differs from previous findings, showing that 49% of female runners returned within 6 weeks 5 . At 12 weeks, it is conceivable that adequate tissue healing had occurred, allowing females to successfully return-torunning even if they were unaware of any perineal tearing.…”

Section: Factors Contributing To Postpartum Return-to-runningsupporting

confidence: 49%

Multidisciplinary, biopsychosocial factors contributing to return to running and running related stress urinary incontinence in postpartum women

et al. 2021

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ObjectivesTo examine contributory factors behind postpartum return-to-running and return to pre-pregnancy running level, in addition to risk factors for postpartum running-related stress urinary incontinence (SUI).Methods881 postpartum women completed an online questionnaire. Clinically and empirically derived questions were created relating to running experiences and multidisciplinary, biopsychosocial contributory factors. Logistic regression was used to determine predictors for return-to-running, returning to pre-pregnancy level of running and running-related SUI.ResultsMedian time to first postpartum run was 12 weeks. Running during pregnancy (OR: 2.81 (1.90 to 4.15)), a high weekly running volume (OR: 1.79 (1.22 to 2.63)), lower fear of movement (OR: 0.53 (0.43 to 0.64)) and not suffering vaginal heaviness (OR: 0.52 (0.35–0.76)) increased the odds of return-to-running. Factors that increased the odds of returning to pre-pregnancy running level were a low weekly running volume (OR: 0.38 (0.26 to 0.56)), having more than one child (OR: 2.09 (1.43 to 3.05)), lower fear of movement (OR: 0.78 (0.65 to 0.94)), being younger (OR: 0.79 (0.65 to 0.96)) and shorter time to running after childbirth (OR: 0.74 (0.60 to 0.90)). Risk factors for running-related SUI were having returned to running (OR: 2.70 (1.51 to 4.76)) and suffering running-related SUI pre-pregnancy (OR: 4.01 (2.05 to 7.82)) and during pregnancy (OR: 4.49 (2.86 to 7.06)); having a caesarean delivery decreased the odds (OR: 0.39 (0.23 to 0.65)).ConclusionRunning during pregnancy may assist women safely return-to-running postpartum. Fear of movement, the sensation of vaginal heaviness and running-related SUI before or during pregnancy should be addressed early by healthcare providers.

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Section: Factors Contributing To Postpartum Return-to-runningsupporting

confidence: 49%

Multidisciplinary, biopsychosocial factors contributing to return to running and running related stress urinary incontinence in postpartum women

et al. 2021

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“…7 8 In 2016, the International Olympic Committee (IOC) convened a meeting of experts in prenatal exercise and produced five documents reviewing available literature regarding pregnant athletes. [9][10][11][12][13] At that time, there was minimal information regarding the safety and benefits of high-intensity, long-duration or extreme volumes of exercise. More recent work suggests elite sport participation during pregnancy is not associated with adverse events during pregnancy, labour or delivery.…”

Section: Introductionmentioning

confidence: 99%

“…In 2016, the International Olympic Committee (IOC) convened a meeting of experts in prenatal exercise and produced five documents reviewing available literature regarding pregnant athletes 9–13. At that time, there was minimal information regarding the safety and benefits of high-intensity, long-duration or extreme volumes of exercise.…”

Section: Introductionmentioning

confidence: 99%

Pushing for change: a qualitative study of the experiences of elite athletes during pregnancy

et al. 2022

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ObjectivesAthletes train and compete at the elite level during their reproductive years, yet sport policies that support pregnant athletes are lacking. The experiences of elite athletes during pregnancy are vastly under-represented, and such voices are needed to support evidence-informed policy. Thus, the purpose of this qualitative study was to describe the experiences of elite female athletes as they navigate pregnancy, and to identify sport policy considerations regarding participation during pregnancy.MethodsTwenty athletes (mean age 35±5 years) who, within the last 5 years, had trained or competed at the elite level immediately prior to becoming pregnant were included. Data were generated via one-on-one semistructured interviews that were audio-recorded, transcribed verbatim and analysed through a process of content analysis.ResultsThe findings of this study are represented by one overarching message: mother versus athlete, and five main themes: (1) pregnancy planning and fertility, (2) pregnancy disclosure and discrimination, (3) training pregnant athletic bodies, (4) safety concerns, and (5) supportive network and equitable funding.ConclusionIn-depth stories shared by participants highlight the many significant decisions athletes must make as they navigate pregnancy alongside elite sport participation. The shared experiences of pregnant athletes highlight clear challenges that should be considered in the development of sport policy and practices that are inclusive and supportive of female athletes.

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“…However, recent studies found no deleterious effect on the pelvic floor investigating cross-fit athletes performing heavy lifts (80% of maximum) during pregnancy (Middlekauff et al, 2016). In summary, few studies have investigated the impact of strenuous endurance training and/or heavy strength training during pregnancy in elite endurance athletes (Bo et al, 2017a), and more research is needed to develop more specific recommendations for top athletes.…”

Section: Introductionmentioning

confidence: 99%

Training Characteristics During Pregnancy and Postpartum in the World’s Most Successful Cross Country Skier

Solli

Sandbakk

2018

Front. Physiol.

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This case-study investigated the training characteristics, physiological capacity, and body composition of the world’s most successful cross country skier during the 40-week pregnancy, and the 61-week postpartum. Training data was systemized by training form (endurance, strength, and speed), intensity [low- (LIT), moderate- (MIT), and high-intensity training (HIT)], and mode (running, cycling, and skiing/roller skiing). The training volume [mean ± standard deviation (median)] during pregnancy was 12.9 ± 7.3(10.0) h/week in the first- (weeks 1–12), 18.3 ± 2.9(18.0) h/week in the second- (weeks 13–28), and 8.8 ± 4.4(9.6) h/week in the third trimester (weeks 29–40). Endurance training time was distributed into 10.9 ± 6.2(9.9), 15.2 ± 2.3(15.6), and 7.6 ± 3.8(7.9) LIT and 0.4 ± 0.5(0.0), 1.3 ± 0.4(1.4), and 0.7 ± 0.6(0.8) h/week MIT during the three trimesters. Only 2.2 h of HIT was performed during the entire pregnancy. During the first two trimesters, the distribution of exercise modes were approximately the same as pre-pregnancy, but the amount of running was reduced during the third trimester. Training volume during the postpartum periods 1–4 was 6.6 ± 3.8(7.1) (PP1; weeks 1–6), 14.1 ± 3.4(14.3) (PP2; weeks 7–12), 10.6 ± 3.8(10.4) (PP3; weeks 13–18), and 13.6 ± 4.1(14.5) h/week (PP4; weeks 19–24), respectively. Training during PP3 and PP4 was interfered with two fractions in the sacrum, leading to decreased amount of running and MIT/HIT, compensated by increased amounts of cycling. Thereafter, training volume progressively approached the pre-pregnancy values, being 18.0 ± 3.9(18.7) h/week during the general preparation- (weeks 25–44), 17.6 ± 4.4(17.3) h/week during the specific preparation- (weeks 45–53), and 16.9 ± 3.5(17.2) h/week during the competition period (CP; weeks 54–61) leading up to the subsequent world championship. The oxygen uptake at the estimated lactate threshold (LT) decreased to 90% of pre-pregnancy values in the second trimester, but remained to ∼100% in PP3. Body weight and fat-% was higher, while lean body mass and bone mineral density was lower after delivery compared to pre-pregnancy. These measurements gradually changed and were back to ∼pre-pregnancy values during CP. This study indicates that high-level cross country skiers can tolerate high training loads during pregnancy. Although the participant had some postpartum setbacks in her training due to fractures in the sacrum, reduced overall training load, followed by a slower progression and utilization of alternative exercise modes, led to a successful return to competitions.

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Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC expert group meeting, Lausanne. Part 4—Recommendations for future research

Cited by 39 publications

References 6 publications

Multidisciplinary, biopsychosocial factors contributing to return to running and running related stress urinary incontinence in postpartum women

Multidisciplinary, biopsychosocial factors contributing to return to running and running related stress urinary incontinence in postpartum women

Pushing for change: a qualitative study of the experiences of elite athletes during pregnancy

Training Characteristics During Pregnancy and Postpartum in the World’s Most Successful Cross Country Skier

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