Objectives To systematically review studies evaluating one or more components of physical fitness (PF) in pregnant women, to answer two research questions: (1) What tests have been employed to assess PF in pregnant women? and (2) What is the validity and reliability of these tests and their relationship with maternal and neonatal health? Design A systematic review. Data sources PubMed and Web of Science. Eligibility criteria Original English or Spanish full-text articles in a group of healthy pregnant women which at least one component of PF was assessed (field based or laboratory tests). Results A total of 149 articles containing a sum of 191 fitness tests were included. Among the 191 fitness tests, 99 (ie, 52%) assessed cardiorespiratory fitness through 75 different protocols, 28 (15%) assessed muscular fitness through 16 different protocols, 14 (7%) assessed flexibility through 13 different protocols, 45 (24%) assessed balance through 40 different protocols, 2 assessed speed with the same protocol and 3 were multidimensional tests using one protocol. A total of 19 articles with 23 tests (13%) assessed either validity (n=4), reliability (n=6) or the relationship of PF with maternal and neonatal health (n=16). Conclusion Physical fitness has been assessed through a wide variety of protocols, mostly lacking validity and reliability data, and no consensus exists on the most suitable fitness tests to be performed during pregnancy. PROSPERO registration number CRD42018117554.

Rugby Union (rugby) is a full-contact team sport characterised by frequent collision events. Over one third (2.7 million) of global rugby participants are women and girls. Yet, most rugby research, laws, and regulations are derived from the men’s game with limited transferability to the women’s game. This includes research focused on injury and concussion management. Greater insights are urgently required to enable appropriate adaptations and support for all rugby participants. Therefore, this paper presents the protocol for a project that sought to gather insights into the understanding, experiences, and attitudes of players and coaches in women’s rugby regarding key issues of concussion, injury, and training for injury prevention, as well as the implications of the menstrual cycle for training and performance. From August 2020 to November 2020, online, open, cross-sectional surveys for players and coaches were distributed globally through rugby governing bodies and women’s rugby social media platforms using snowball sampling. Survey responses were recorded anonymously via a GDPR-compliant online survey platform, JISC (jisc.ac.uk, Bristol, England). Participant eligibility included being ≥18 years and either actively playing or coaching women’s rugby 15s and/or sevens, or having done so in the past decade, at any level, in any country. To enhance the number and accuracy of responses, the survey was professionally translated into eight additional languages. A total of 1596 participants from 62 countries (27 ± 6 years; 7.5 ± 5.1 years of playing experience) and 296 participants from 37 countries (mean age = 36.64, SD = 9.09, mean experience = 6.53 years, SD = 3.31) completed the players’ and coaches’ surveys, respectively. Understanding women’s participation in and experiences of rugby is important to enable lifelong engagement and enjoyment of the sport and health during and following participation.

Purpose: The potential impact of hormonal contraceptives (HCs) on player health and performance in women’s rugby union (rugby) is not well understood, despite rugby’s growing popularity worldwide. This study investigated the prevalence of HC use and reported associations with training and performance in a global sample of women rugby players. Method: A globally distributed online survey, seeking to explore experiences in women’s rugby, was completed by 1596 current or former adult women 7s or 15s rugby players (mean age 27 [6] y; 7 [5] y playing experience) from 62 countries. The survey included a section of questions about reported HC use, including the type, reason for use, symptoms, and experiences relating to rugby training and performance. Results: A total of 606 (38%) participants from 33 of the 62 (53%) countries reported using HCs, with the combined oral contraceptive pill reported as the most frequently used (44%). Almost half of participants using HCs (43%) tracked HC-related symptoms. Over 10% reported altered rugby performance due to HC-related symptoms, 22% required medication to manage symptoms, and 11% used HCs to control or stop their menstrual periods for rugby training and performance. Conclusions: The current study highlights the prevalence of HC use in women’s rugby, identifying practices that may negatively affect performance, health, and well-being. Thus, there is an urgent need to better understand the motivations for such practices and knowledge of potential side effects among women rugby players across all levels and countries.

This study aims to determine if regular maternal physical exercise leads to measurable adaptations of the fetal autonomic nervous system (fANS) tested by fetal heart rate recovery time. A randomized controlled trial enrolled 131 pregnant women into two study groups, Exercise Group (EG) and Control Group (CG). All participants signed an informed consent, study was approved by the local Clinical Research Ethics Committee. Data was analyzed on 81 participants. EG participants (n = 43) received a supervised physical exercise program (PEP) three times a week from 10–12 to 36–40 weeks gestation. CG participants (n = 38) did not receive any supervised PEP. All women were tested between 34–36 weeks gestation using two walking tests of three minutes each at 40% and 60% maternal heart rate reserve. Resting fetal heart rate (FHR), FHR post-maternal exercise, and fetal recovery time (FRT) in minutes/seconds (m/s) were recorded. Resting FHR was similar between groups 140.88 ± 9 EG vs 141.95 ± 7.35 CG (p > .05). Difference in resting to post-maternal exercise FHR was statistically significant in fetuses from the CG (p < .05), however was not statistically significant in fetuses from the EG (p > .05). FRT was different between groups after both tests: 40% test: 2m15s ± 3m19s EG vs 7m6s ± 5m28s CG (p < .001); 60% test: 3m ± 4m3s EG vs 9m25s ± 7m33s CG (p < .001). There were no significant differences in maternal variables (p > .05), except for maternal recovery time after 40% test (p < .05). Influence of maternal exercise in FHR response still remains unclear. Further research is needed to elicit a former conclusion on the effects of maternal exercise on fANS. Overall, exercise during pregnancy is safe and not harmful for the cardiovascular system of the fetus.