27 Dec 09 Do Pregnant Women Need to Exercise?

Staying active and flexible during and after pregnancy deter the occurrence of preeclampsia (1), severe musculoskeletal complication (2) and gestational diabetes. It also aids in the recovery from childbirth and postpartum weight maintenance.

The ACOG or American College of Obstetricians and Gynecologists endorses moderate-intensity exercise for at least 30 min on most, if not all days of the week for pregnant women. Examples of moderate-intensity exercise are brisk walking, low impact dance aerobics, and biking.

Terry Leet, Ph.D., a study author with Petersen et al, reported in the Medicine & Science in Sports & Exercise Journal, said that women who are pregnant should exercise unless advised otherwise by their doctor due to complications observed during their pregnancy. Women should start an exercise program during pregnancy with moderate, non-weight-bearing activities, such as cycling, brisk walking or swimming. Those who exercised prior to pregnancy should avoid activities that may cause abdominal distress such as contact sports and scuba diving, but should continue to exercise.

In a study reported by Borodulin et al. (2008) 71.6% white, 17.3% African American, 11.1% other of 1,482 women, a majority of them reported some physical activity during the second (96.5%) and third (93.9%) trimester. The level of intensity and total volume of exercise decreased between the second and third trimester. The physical activity reported consists of care-related responsibilities, household indoor related and recreational activities.

Pregnant women who meet the moderate to vigorous physical activity recommendations of the ACOG were more likely to be more educated, non-Hispanic white, younger, not married, of higher incomes, and non-smokers. Those coming from a lower socioeconomic status and smoked were less likely to meet the physical activity recommendations during pregnancy. However, majority of the women did not reach the activity recommendations set by the ACOG.

What is surprising is that despite its benefits, exercise seems to be losing its appeal. Pregnant women who worked out at least three times a week declined from 9% in 1994 to 6% in 2000. The same goes for non-pregnant women. Activity levels decreased from 17% in 1996 to 14% in 2000. Worse, pregnant women who needed to exercise were the same ones who were not getting enough exercise when they were not pregnant. Therefore, they would be less likely to start exercising in the first place.

According to Dr. Raul Artal of the American College of Obstetrics and Gynecology, obstetricians are hesitant to recommend exercise to pregnant women. He believes that it is rooted in the old-fashioned notions of pregnancy as a time of rest and accouchement.

Physicians, fitness professionals and personal trainers should encourage physical activity during pregnancy with proper education of the health benefits of exercise during and after pregnancy. They should point out that the American College of Obstetricians and Gynecologists has adopted the Center for Disease Control exercise guidelines: everyone should get at least 30 minutes of moderate exercise every day. Moderate regular exercise is beneficial to both the mother and the fetus. It can also improve overall cardiovascular health, well being and decreased risk for gestational diabetes.

References:

Borodulin, K.M., Evenson, K.R., Wen, F., Herring, A.H., and Benson, A.M. (2008). Physical activity patterns during pregnancy. Medicine & Science in Sports & Exercise, 40(11), 1901-1908.

Petersen et al, Correlate of Physical Activity among Pregnant Women in the United States, Medicine & Science in Sports & Exercise; Nov. 2005; p.1748-1753.

Definition of some terms:

1) Preeclampsia - abnormal state of pregnancy identified by fluid retention and hypertension

2) Musculoskeletal complications - discomfort in the back, pelvis and tenderness of the lower extremities.

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