Exercise in Pregnancy

Abstract

A greater number of women are choosing to exercise in pregnancy as the recommendations by the American College of Obstetrics and Gynecology (ACOG) and other organizations have changed in recent years. Exercise during pregnancy can be beneficial to the health of the fetus and mother. Physicians should be aware of the contraindications to exercise, the warning signs to terminate exercise, and the latest recommendations by the ACOG. In the absence of contraindications, the authors believe that physicians should help to develop a reasonable exercise protocol for women based upon their previous activity levels. It is incumbent upon physicians to be aware of the unique physiologic factors present during pregnancy that may predispose women to injuries. Treatment of injuries sustained during pregnancy must balance the risks to both the mother and fetus.

Effect of a Exercise by Pregnant Women and Birth Weight: A Randomized Controlled Trial

“…The exercise-program followed the ACOG exercise prescription. [1,27] The exercise program was choreographed and led by certified aerobic-instructors, and each session included a maximum of 20 participants.…”

South African Sports Medicine Association Position Statement on Exercise in Pregnancy

“…An upper level of safe exercise intensity has not been established and the Center for Disease Control (CDC) and American College of Sports Medicine (ACSM)'s definitions of moderate exercise of 3 -4 METS (metabolic equivalent where 1 MET=3.5 ml O 2 consumed/kg body weight/minute) 10 or any activity that is equivalent in intensity to brisk walking can also be applied in pregnancy. 1,5,9 In a meta-analysis study of exercise and pregnancy, it was reported that with exercise intensities of 81% of maximum heart rate, no significant adverse effects were found. 7 Likewise, the ACOG guidelines has no heart rate limitation and therefore also supports a more liberal approach.…”

Efectos de un programa de ejercicio físico supervisado sobre la estructura cardiaca durante la gestación. Ensayo clínico aleatorizado

“…La diferencia arterio-venosa de oxígeno se reduce considerablemente al inicio del embarazo 14 . Sin embargo, se mantiene un elevado aporte de oxígeno a los tejidos debido al aumento del gasto cardiaco, el volumen sistólico y la frecuencia cardiaca, siendo esta última fundamental al inicio del embarazo 13 .…”

“…Esta vasodilatación periférica mantiene la presión arterial en valores normales a pesar del aumento del volumen sanguíneo 14 , o incluso desciende en el primer trimestre, y alcanza su valor mínimo hacia la mitad del embarazo volviendo a recuperarse al final del mismo. Los cambios en la tensión sistólica son relativamente insignificantes 15 .…”

“…Por ello, el diseño de este programa de ejercicio físico se apoyó en las líneas directrices del ACOG 21 , ya que se trata de unas líneas de actuación básicas y seguras mantenidas por casi la totalidad de los trabajos de investigación consultados 11,14,[21][22][23][24][25] . Todas las sesiones fueron desarrolladas en las instalaciones del Hospital Universitario de Fuenlabrada, en una sala ventilada, con luz natural, con música de apoyo, y con favorables condiciones ambientales (altitud alrededor de 600 m, temperatura comprendida entre los 19 y los 21 8C y una humedad relativa entre 50-60%).…”