The impact of exercise on pregnancy: a comprehensive examination of benefits, risks, and considerations

Authors

  • Shiva Fayyazi Moghaddam Universal Scientific Education and Research Network (USERN), Tehran, Tehran Province, Iran

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20241465

Keywords:

Pregnancy, Exercise, Gestational diabetes, Hypertension, Maternal health, Fetal health

Abstract

Pregnancy represents a crucial developmental stage characterized by notable physiological transformations. The significance of maintaining an active lifestyle during this period is widely acknowledged as a crucial element of prenatal health, providing a multitude of advantages for the overall well-being of both the mother and the fetus. This article offers a comprehensive examination of the role of exercise during pregnancy, delving into the physiological adjustments, suggested recommendations, and the potential advantages and drawbacks. Physical activity during pregnancy has been shown to have positive effects on weight management, the prevention of gestational diabetes and hypertensive diseases, as well as the enhancement of mood, body image, and sleep quality. There is a positive impact on fetal health outcomes, including ideal birth weight and enhanced heart rate patterns. Nevertheless, some medical issues and complications during pregnancy may necessitate adjustments or contraindications to activity. Although the advantages of exercise are well recorded, numerous pregnant women encounter obstacles when it comes to engaging in physical activity. Healthcare practitioners assume a pivotal role in resolving these problems and facilitating the promotion of safe and effective exercise among expecting moms. Additional investigation is required to clarify the most beneficial exercise recommendations, ascertain efficacious intervention approaches, and advocate for exercise as an essential element of prenatal healthcare.

References

Bhat RA, Kushtagi P. A re-look at the duration of human pregnancy. Singapore Med J. 2006;47(12):1044-8.

Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovascular J Afr. 2016;27(2):89-94.

Haakstad LAH, Vistad I, Sagedal LR, Lohne-Seiler H, Torstveit MK. How does a lifestyle intervention during pregnancy influence perceived barriers to leisure-time physical activity? The Norwegian fit for delivery study, a randomized controlled trial. BMC Pregnancy Childbirth. 2018;18(1):127.

Chan CWH, Au Yeung E, Law BMH. Effectiveness of Physical Activity Interventions on Pregnancy-Related Outcomes among Pregnant Women: A Systematic Review. Int J Environmental Res Publ Heal. 2019;16(10).

Skjold I, Benvenuti MB, Haakstad LA. Why do so many pregnant women give up exercise? An Italian cross-sectional study. Women's Health (London, England). 2022;18:17455057221117967.

Poudevigne MS, O'Connor PJ. A review of physical activity patterns in pregnant women and their relationship to psychological health. Sports Med (Auckland, NZ). 2006;36(1):19-38.

Paulsen CP, Bandak E, Edemann-Callesen H, Juhl CB, Händel MN. The Effects of Exercise during Pregnancy on Gestational Diabetes Mellitus, Preeclampsia, and Spontaneous Abortion among Healthy Women-A Systematic Review and Meta-Analysis. Int J Environmental Res Publ Heal. 2023;20(12).

Hammer RL, Perkins J, Parr R. Exercise during the childbearing year. J Perinatal Educat. 2000;9(1):1-14.

L'Heveder A, Chan M, Mitra A, Kasaven L, Saso S, Prior T, et al. Sports Obstetrics: Implications of Pregnancy in Elite Sportswomen, a Narrative Review. J Clin Med. 2022;11(17):1.

Okafor UB, Goon DT. Uncovering Barriers to Prenatal Physical Activity and Exercise Among South African Pregnant Women: A Cross-Sectional, Mixed-Method Analysis. Frontiers Publ Heal. 2022;10:697386.

Okafor UB, Goon DT. Physical Activity Advice and Counselling by Healthcare Providers: A Scoping Review. Healthcare (Basel, Switzerland). 2021;9(5).

Hall ME, George EM, Granger JP. [The heart during pregnancy]. Revista espanola de cardiologia. 2011;64(11):1045-50.

Bossung V, Singer A, Ratz T, Rothenbühler M, Leeners B, Kimmich N. Changes in Heart Rate, Heart Rate Variability, Breathing Rate, and Skin Temperature throughout Pregnancy and the Impact of Emotions-A Longitudinal Evaluation Using a Sensor Bracelet. Sensors (Basel, Switzerland). 2023;23(14).

Boeldt DS, Bird IM. Vascular adaptation in pregnancy and endothelial dysfunction in preeclampsia. J Endocrinol. 2017;232(1):R27-44.

VanWijk MJ, Kublickiene K, Boer K, VanBavel E. Vascular function in preeclampsia. Cardiovasc Res. 2000;47(1):38-48.

Zhang S, Regnault TR, Barker PL, Botting KJ, McMillen IC, McMillan CM, et al. Placental adaptations in growth restriction. Nutrients. 2015;7(1):360-89.

Fukano M, Tsukahara Y, Takei S, Nose-Ogura S, Fujii T, Torii S. Recovery of Abdominal Muscle Thickness and Contractile Function in Women after Childbirth. Int J Environm Res Publ Health. 2021;18(4):10.

Fisher M, Bordoni B. Anatomy, Bony Pelvis and Lower Limb, Pelvic Joints. PubMed. 2021.

Dehghan F, Haerian BS, Muniandy S, Yusof A, Dragoo JL, Salleh N. The effect of relaxin on the musculoskeletal system. Scandinavian J Med Sci Sports. 2014;24(4):e220-9.

Sarkar PK, Singh P, Dhillon MS, Bhattacharya S, Singh A. Postural deviation in pregnancy: A significant debilitating balance problem which can be rectified by physiotherapeutic intervention. J Family Med Primary Care. 2022;11(7):3717-25.

Casagrande D, Gugala Z, Clark SM, Lindsey RW. Low Back Pain and Pelvic Girdle Pain in Pregnancy. J Am Academy Orthopaedic Surgeons. 2015;23(9):539-49.

Ribeiro MM, Andrade A, Nunes I. Physical exercise in pregnancy: benefits, risks and prescription. J Perinat Med. 2022;50(1):4-17.

Current Guidelines | health.gov. healthgov. 2021.

Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstetr Gynecol. 2020;135(4):e178-88.

Evenson KR, Hesketh KR. Monitoring Physical Activity Intensity During Pregnancy. Am J Lifestyle Med. 2023;17(1):18-31.

Gascoigne EL, Webster CM, Honart AW, Wang P, Smith-Ryan A, Manuck TA. Physical activity and pregnancy outcomes: an expert review. Am J Obstetr Gynecol MFM. 2023;5(1):100758.

Ehrlich SF, Ferrara A, Hedderson MM, Feng J, Neugebauer R. Exercise During the First Trimester of Pregnancy and the Risks of Abnormal Screening and Gestational Diabetes Mellitus. Diabetes Care. 2021;44(2):425-32.

Harmsworth M, Savona-Ventura C, Mahmood T. High-intensity exercise during pregnancy – A position paper by the European Board and College of Obstetrics and Gynaecology (EBCOG). Eur J Obstetr Gynecol Reproduct Biol. 2023;285:56-8.

Kasoha M, Hamza A, Leube A, Solomayer EF, Frenzel J, Schwab R, et al. Physical Activity and the Impact of Continued Exercise on Health-Related Quality of Life Prior to and during Pregnancy: A German Cohort Study. Healthcare (Basel, Switzerland). 2023;11(15):2.

Huberty JL, Buman MP, Leiferman JA, Bushar J, Adams MA. Trajectories of objectively-measured physical activity and sedentary time over the course of pregnancy in women self-identified as inactive. Preventive Med Rep. 2016;3:353-60.

Ko YL, Chen CP, Lin PC. Physical activities during pregnancy and type of delivery in nulliparae. Eur J Sport Sci. 2016;16(3):374-80.

Langley-Evans SC, Pearce J, Ellis S. Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review. J Human Nutr Dietetics. 2022;35(2):250-64.

Nakshine VS, Jogdand SD. A Comprehensive Review of Gestational Diabetes Mellitus: Impacts on Maternal Health, Fetal Development, Childhood Outcomes, and Long-Term Treatment Strategies. Cureus. 2023;15(10):e47500.

Lust O, Chongsuwat T, Lanham E, Chou AF, Wickersham E. Does Exercise Prevent Gestational Diabetes Mellitus in Pregnant Women? A Clin-IQ. J Patient-Centered Res Rev. 2021;8(3):281-5.

Wai-Kit M, Wenjing D, Casper JPZ, Lieqiang Z, Yuhang L, Zhuyu L, et al. The effect of exercise during pregnancy on gestational diabetes mellitus in normal-weight women: en: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2018;18(1):440.

Dipla K, Zafeiridis A, Mintziori G, Boutou AK, Goulis DG, Hackney AC. Exercise as a Therapeutic Intervention in Gestational Diabetes Mellitus. Endocrines. 2021;2(2):65-78.

Poon LC, Nguyen-Hoang L, Smith GN, Bergman L, O'Brien P, Hod M, et al. Hypertensive disorders of pregnancy and long-term cardiovascular health: FIGO Best Practice Advice. Int J Gynecol Obstetr. 2023;160(S1):22-34.

Witvrouwen I, Mannaerts D, Van Berendoncks AM, Jacquemyn Y, Van Craenenbroeck EM. The Effect of Exercise Training During Pregnancy to Improve Maternal Vascular Health: Focus on Gestational Hypertensive Disorders. Frontiers Physiol. 2020;11:450.

Bjelica A, Cetkovic N, Trninic-Pjevic A, Mladenovic-Segedi L. The phenomenon of pregnancy - a psychological view. Ginekologia Polska. 2018;89(2):102-6.

Kołomańska D, Zarawski M, Mazur-Bialy A. Physical Activity and Depressive Disorders in Pregnant Women-A Systematic Review. Medicina (Kaunas, Lithuania). 2019;55(5):2.

Uluoz E, Toros T, Ogras EB, Temel C, Korkmaz C, Keskin MT, et al. The Impact of Sustainable Exercise and the Number of Pregnancies on Self-Efficacy, Self-Esteem, and Assertiveness Levels in Pregnant Women. Sustainability. 2023;15(11):1-5.

Kember AJ, Elangainesan P, Ferraro ZM, Jones C, Hobson SR. Common sleep disorders in pregnancy: a review. Front Med (Lausanne). 2023;10:1235252.

Shen W-C, Chen C-H. Effects of non-supervised aerobic exercise on sleep quality and maternal-fetal attachment in pregnant women: A randomized controlled trial. Complementary Therapies in Medicine. 2021;57:102671.

Vargas-Terrones M, Nagpal TS, Barakat R. Impact of exercise during pregnancy on gestational weight gain and birth weight: an overview. Braz J Physical Therapy. 2019;23(2):164-9.

Chae SA, Son JS, Du M. Prenatal exercise in fetal development: a placental perspective. FEBS J. 2022;289(11):3058-71.

May LE, Knowlton J, Hanson J, Suminski R, Paynter C, Fang X, et al. Effects of Exercise During Pregnancy on Maternal Heart Rate and Heart Rate Variability. PM R. 2016;8(7):611-7.

May LE, Glaros A, Yeh H-W, Clapp JF, Gustafson KM. Aerobic exercise during pregnancy influences fetal cardiac autonomic control of heart rate and heart rate variability. Early Human Development. 2010;86(4):213-7.

Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, et al. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstetr Gynecol. 2016;215(1):103.e1-14.

Cai M, Zhang B, Yang R, Zheng T, Dong G, Lin H, et al. Association between maternal outdoor physical exercise and the risk of preterm birth: a case-control study in Wuhan, China. BMC Pregnancy and Childbirth. 2021;21(1):206.

Masenga SK, Kirabo A. Hypertensive heart disease: risk factors, complications and mechanisms. Frontiers Cardiovascular Med. 2023;10:1205475.

Vyawahare AP, Gaidhane A, Wandile B. Asthma in Pregnancy: A Critical Review of Impact, Management, and Outcomes. Cureus. 2023;15(12):e50094.

Spruit MA, Burtin C, De Boever P, Langer D, Vogiatzis I, Wouters EF, et al. COPD and exercise: does it make a difference? Breathe (Sheffield, England). 2016;12(2):e38-49.

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 15. Management of Diabetes in Pregnancy: Standards of Care in Diabetes-2023. Diabetes Care. 2022;46(1):S254-66.

Lee R, Thain S, Tan LK, Teo T, Tan KH. Asia-Pacific consensus on physical activity and exercise in pregnancy and the postpartum period. BMJ open sport and exercise medicine. 2021;7(2):e000967.

Artal R, Sherman C. Exercise during pregnancy: safe and beneficial for most. Physician Sports Med. 1999;27(8):51-75.

Ravanelli N, Casasola W, English T, Edwards KM, Jay O. Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis. Brit J Sports Med. 2019;53(13):799-805.

Cooper DB, Yang L. Pregnancy And Exercise. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2024.

Aldabe D, Ribeiro DC, Milosavljevic S, Dawn Bussey M. Pregnancy-related pelvic girdle pain and its relationship with relaxin levels during pregnancy: a systematic review. Eur Spine J. 2012;21(9):1769-76.

Bergqvist D, Hedelin H, Karlsson G, Lindblad B, Mätzsch T. Abdominal injury from sporting activities. Brit J Sports Med. 1982;16(2):76-9.

Aguiar L, Santos-Rocha R, Vieira F, Branco M, Andrade C, Veloso A. Comparison between overweight due to pregnancy and due to added weight to simulate body mass distribution in pregnancy. Gait Posture. 2015;42(4):511-7.

Padayachee C, Coombes JS. Exercise guidelines for gestational diabetes mellitus. World J Diab. 2015;6(8):1033-44.

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Published

2024-05-29

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Review Articles