Introduction. Women attain numerous benefits from physical activity during pregnancy. However, because of physical changes that occur during pregnancy, special precautions are also needed. This review summarizes current guidelines for physical activity among pregnant women worldwide. Methods. 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. Results. In total, 11 guidelines were identified from 9 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 guidelines included absolute and relative contraindications to exercise. All guidelines generally ruled-out sports with risks of falls, trauma, or collisions. Six guidelines included indications for stopping exercise during pregnancy. Conclusion. This review contrasted pregnancy-related physical activity guidelines from around the world, and can help inform new guidelines as they are created or updated and facilitate the development of a worldwide guideline.

Excess gestational weight gain is associated with short‐ and long‐term pregnancy complications. Although a healthy diet and physical activity during pregnancy are recommended and shown to reduce the risk of complications and improve outcomes, adherence to these recommendations is low. The aims of this study were to explore women's view of nutrition and physical activity during pregnancy and to describe barriers and facilitators experienced in implementing physical activity and nutrition recommendations. In a substudy of the Be Healthy in Pregnancy randomized trial, 20 semistructured focus groups were conducted with 66 women randomized to the control group when they were between 16 and 24 weeks gestation. Focus groups were recorded, transcribed verbatim, coded and thematically analysed. The results indicate that women felt motivated to be healthy for their baby, but competing priorities may take precedence. Participants described limited knowledge and access to information on safe physical activity in pregnancy and lacked the skills needed to operationalize both physical activity and dietary recommendations. Women's behaviours regarding diet and physical activity in pregnancy were highly influenced by their own and their peers' beliefs and values regarding how weight gain impacted their health during pregnancy. Pregnancy symptoms beyond women's control such as fatigue and nausea made physical activity and healthy eating more challenging. Counselling from care providers about nutrition and physical activity was perceived as minimal and ineffective. Future interventions should address improving counselling strategies and address individual's beliefs around nutrition and activity in pregnancy.

Tched by prepregnant body mass index, age, and parity to a historical cohort (4:1). Women with a prepregnancy body mass index of ≥25.0 kg·m−2 (N = 65) participated in a NELIP starting at 16-20 wk of pregnancy, continuing until delivery. NELIP consisted of an individualized nutrition plan with total energy intake of approximately 2000 kcal·d−1 (8360 kJ·d−1) and 40%-55% of total energy intake from carbohydrate. Exercise consisted of a walking program (30% HR reserve), three to four times per week, using a pedometer to count steps. Matched historical cohort (MC; N = 260) was from a large local perinatal database. Results: Weight gained by women on the NELIP was 6.8 ± 4.1 kg (0.38 ± 0.2 kg·wk−1), with a total pregnancy weight gain of 12.0 ± 5.7 kg. Excessive weight gain occurred before NELIP began at 16 wk of gestation. Eighty percent of the women did not exceed recommended pregnancy weight gain on NELIP. Weight retention at 2 months postpartum was 2.2 ± 5.6 kg with no difference between the OW and the OB women on NELIP. Mean birth weight was not different between NELIP (3.59 ± 0.5 kg) and MC (3.56 ± 0.6 kg, P > 0.05). Conclusions: NELIP reduces the risk of excessive pregnancy weight gain with minimal weight retention at 2 months postpartum in OW and OB women. This intervention may assist OW and OB women in successful weight control after childbirth....

Men between 16 and 22 wk of gestation performed the test to volitional fatigue (peak exercise test). Data from every fourth subject were used to form the cross-validation group. The women were separated into two age groups; 20-29 (N = 60) and 30-39 (N = 96) yr of age and then further separated into fit (V̇O2peak at the top 25th percentile), unfit (V̇O2peak at the bottom 25th percentile), and active (between these two ranges). HR and V̇O2peak values were used in the regression equation to predict target HR ranges at 60 and 80% V̇O2peak. Results: The prediction equation (R2 = 0.72, R2adjusted = 0.71 and SEE = 2.7) was compared with cross validation (N = 39; P = 0.78). Fit women had a V̇O2peak ≥ 27.2 mL·kg−1·min−1 and ≥ 26.1 mL·kg−1·min−1 for ages 20-29 and 30-39 yr, respectively, representing the top 25th percentile. Unfit women had a V̇O2peak of ≤ 21.0 mL·kg−1·min−1 and ≤ 19.6 mL·kg−1·min−1, respectively, representing the bottom 25th percentile. HR/V̇O2peak regression lines for each fitness level were used to generate the target HR zones in each age group. Conclusion: This is the first study to provide a validated prediction equation of V̇O2peak for pregnant women using a progressive treadmill exercise test. The defined target HR zones based on age and the appropriate fitness levels can be used for exercise prescription in healthy pregnant women....

Postpartum physical activity can improve mood, maintain cardiorespiratory fitness, improve weight control, promote weight loss, and reduce depression and anxiety. This review summarizes current guidelines for postpartum physical activity worldwide. PubMed (MEDLINE) was searched for country-specific government and clinical guidelines on physical activity after pregnancy through the year 2013. Only the most recent guideline was included in the review. An abstraction form facilitated extraction of key details and helped to summarize results. Six guidelines were identified from 5 countries (Australia, Canada, Norway, United Kingdom, and United States). All guidelines were embedded within pregnancy-related physical activity recommendations. All provided physical activity advice related to breastfeeding and 3 remarked about physical activity after cesarean delivery. Recommended physical activities mentioned in the guidelines included aerobic (3/6), pelvic floor exercise (3/6), strengthening (2/6), stretching (2/6), and walking (2/6). None of the guidelines discussed sedentary behavior. The guidelines that were identified lacked specificity for physical activity. Greater clarity in guidelines would be more useful to both practitioners and the women they serve. Postpartum physical activity guidelines have the potential to assist women to initiate or resume physical activity after childbirth so that they can transition to meeting recommended levels of physical activity. Health care providers have a critical role in encouraging women to be active at this time, and the availability of more explicit guidelines may assist them to routinely include physical activity advice in their postpartum care. Target Audience Obstetricians and gynecologists, family physicians Learning Objectives After completing this CME activity, physicians should be better able to describe the benefits of physical activity identified in postpartum physical activity guidelines, discuss the impacts of physical activity on breastfeeding as described in postpartum physical activity guidelines, and assess the limitations of the current postpartum physical activity guidelines.