Exercise during pregnancy has been recognized as a safe and beneficial practice for both the mother and the developing fetus. However, it is crucial to consider certain indications and contraindications to ensure the well-being and safety of pregnant women. This paper will discuss the evidence-based indications and contraindications for exercise during pregnancy.

Indications:

Healthy Pregnancy
A healthy pregnancy without any complications is a primary indication for exercise. Research by Mottola et al. (2018) emphasizes the importance of regular physical activity in maintaining maternal health and reducing the risk of gestational diabetes and preeclampsia (1).

Gestational Diabetes
Pregnant women with gestational diabetes can benefit from exercise. According to Barakat et al. (2019), exercise interventions significantly improve glycemic control and reduce the need for insulin therapy (2).

Pre-pregnancy Obesity
Exercise is recommended for women who were obese before pregnancy. Ruchat et al. (2018) suggest that exercise during pregnancy can prevent excessive gestational weight gain and reduce the risk of complications associated with obesity, such as gestational hypertension and gestational diabetes (3).

Mood Disorders
Exercise can be beneficial for pregnant women experiencing mood disorders, such as depression or anxiety. An article by Daley et al. (2015) reports that physical activity interventions during pregnancy can reduce depressive symptoms and improve psychological well-being (4).

Contraindications:

Preterm Labor
Exercise should be avoided in cases of known or suspected preterm labor. The American College of Obstetricians and Gynecologists (ACOG) guidelines state that women with a history of preterm labor, current preterm labor, or premature rupture of membranes should not engage in exercise (5).

Incompetent Cervix
Women with an incompetent cervix, a condition characterized by the inability of the cervix to support a pregnancy, should avoid exercise. The ACOG guidelines advise against exercise in such cases (5).

Conclusion

Exercise during pregnancy is generally safe and beneficial for most women. However, specific indications and contraindications should be considered to ensure maternal and fetal well-being. Regular physical activity is recommended for healthy pregnancies, gestational diabetes, pre-pregnancy obesity, and mood disorders. Conversely, exercise should be avoided in cases of preterm labor, multiple gestation, severe preeclampsia, and incompetent cervix. Adherence to evidence-based guidelines will help healthcare providers make informed decisions regarding exercise prescriptions during pregnancy.

Agata Mroczek

References:

1. Mottola MF, Davenport MH, Ruchat SM, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018;52(21):1339-1346. doi:10.1136/bjsports-2018-100056
2. Barakat R, Perales M, Cordero Y et al. Exercise during pregnancy protects against gestational diabetes mellitus: a systematic review and meta-analysis. Eur J Endocrinol. 2019;181(4), 369-383.
3. Ruchat SM, Mottola MF, Skow RJ, et al. Effectiveness of exercise interventions in the prevention of excessive gestational weight gain and postpartum weight retention: a systematic review and meta-analysis. Br J Sports Med. 2018;52(21):1347-1356. doi:10.1136/bjsports-2018-099399
4. Daley AJ, Foster L, Long G, et al. The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta-analysis. BJOG. 2015;122(1):57-62. doi:10.1111/1471-0528.12909
5. Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020;135(4):e178-e188. doi:10.1097/AOG.0000000000003772