Skip to main content
SpringerLink
Log in

Obesity and Physical Activity During Pregnancy and Postpartum: Evidence, Guidelines, and Recommendations

  • Chapter
  • First Online:
Obesity During Pregnancy in Clinical Practice

Abstract

This chapter provides clinicians and researchers with an overview of the physical activity and pregnancy/postpartum literature to promote physical activity, understand the determinants and outcomes of physical activity participation among pregnant and postpartum women, recognize the scant literature pertaining to overweight and obese women, and inform next steps in practice, prevention, and research. We discuss (a) physical activity guidelines; (b) prevalence rates of physical activity during pregnancy and postpartum; (c) determinants, health outcomes, and critical gaps in the literature of pre- and postnatal physical activity; and (d) recommendations for research and practice to facilitate physical activity initiation, motivation, and maintenance across the transition to motherhood.

Those who think they have not time for bodily exercise will sooner or later have to find time for illness. Edward Stanley, Earl of Derby, 1873

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. 2008 Physical Activity Guidelines for Americans. Washington (D.C.): U.S. Department of Health and Human Services; 2008. ODPHP Publication No. U0036

    Google Scholar 

  2. ACOG. Exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 267. Obstet Gynecol. 2002;99(1):171–3.

    Google Scholar 

  3. Brown W. The benefits of physical activity during pregnancy. J Sci Med Sport. 2002;5(1):37–45.

    PubMed  CAS  Google Scholar 

  4. Pivarnik JM, Chambliss H, Clapp III J, Dugan S, Hatch M, Lovelady C, Mottola MF, Williams M. Impact of physical activity during pregnancy and postpartum on chronic disease risk. Med Sci Sports Exerc. 2006;38(5):989–1006.

    Google Scholar 

  5. Larson-Meyer DE. Effect of postpartum exercise on mothers and their offspring: a review of the literature. Obes Res. 2002;10(8):841–53.

    PubMed  Google Scholar 

  6. Sampselle C, Seng J, Yeo S, Killion C, Oakley D. Physical activity and postpartum well-being. J Obstet Gynecol Neonatal Nurs. 1999;28(1):41–9.

    PubMed  CAS  Google Scholar 

  7. Federal Security Agency and Social Security Administration. Prenatal Care. 1949;4:25–26.

    Google Scholar 

  8. Sternfeld B. Physical activity and pregnancy outcome: review and recommendations. Sports Med. 1997;23(1):33–47.

    PubMed  CAS  Google Scholar 

  9. Exercise during pregnancy and the postnatal period. Washington (D.C.): American College of Obstetricians and Gynecologists; 1985. 1–6 ACOG Home Exercise Programs.

    Google Scholar 

  10. ACOG. Exercise during pregnancy and the postpartum period. ACOG Technical Bulletin Number 189. Int J Gynaecol Obstet. 1994;45(1):65–70.

    Google Scholar 

  11. Zavorsky GS, Longo LD. Adding strength training, exercise intensity, and caloric expenditure to exercise guidelines in pregnancy. Obstet Gynecol. 2011;117(6):1399–402.

    PubMed  Google Scholar 

  12. Entringer S, Buss C, Swanson JM, Cooper DM, Wing DA, Waffarn F, Wadhwa PD. Fetal programming of body composition, obesity, and metabolic function: the role of intrauterine stress and stress biology. J Nutr Metab. 2012;2012:632548. doi:10.1155/2012/632548

  13. Mottola MF. Exercise prescription for overweight and obese women: pregnancy and postpartum. Obstet Gynecol Clin North Am. 2009;36(2):301–16.

    PubMed  Google Scholar 

  14. Evenson K, Wen F. National trends in self-reported physical activity and sedentary behaviors among pregnant women: NHANES 1999–2006. Prev Med. 2010;50:123–8.

    PubMed  Google Scholar 

  15. Welk G, editor. Physical activity assessments for health-related research. Champaign: Human Kinetics; 2002.

    Google Scholar 

  16. Evenson K, Wen F. National prevalence and correlates of objectively measured physical activity and sedentary behaviors among pregnant women. Prev Med. 2011;53:39–43.

    PubMed  Google Scholar 

  17. Chang MW, Nitzke S, Guilford E, Adair CH, Hazard DL. Motivators and barriers to healthful eating and physical activity among low-income overweight and obese mothers. J Am Diet Assoc. 2008;108(6):1023–8.

    PubMed  Google Scholar 

  18. Albright C, Maddock JE, Nigg CR. Physical activity before pregnancy and following childbirth in a multiethnic sample of healthy women in Hawaii. Women Health. 2005;42(3):95–110.

    PubMed  Google Scholar 

  19. Groth SW, David T. New mothers’ views of weight and exercise. MCN Am J Matern Child Nurs. 2008;33(6):364–70.

    PubMed  Google Scholar 

  20. Kieffer E, Willis S, Arellano N, Guzman R. Perspectives of pregnant and postpartum Latino women on diabetes, physical activity, and health. Health Educ Behav. 2002;29(5):542–56.

    PubMed  Google Scholar 

  21. Carter-Edwards L, Ostbye T, Bastian LA, Yarnall K, Krause KM, Simmons TJ. Barriers to adopting a healthy lifestyle: insight from postpartum women. BMC Res Notes. 2009;2:161.

    PubMed  Google Scholar 

  22. Setse R, Grogan R, Cooper LA, Strobino D, Powe NR, Nicholson W. Weight loss programs for urban-based, postpartum African-American women: perceived barriers and preferred components. Matern Child Health J. 2008;12(1):119–27.

    PubMed  Google Scholar 

  23. Thornton P, Kieffer E, Salabarria-Pena Y, Odoms-Young A, Willis S, Kim H, et al. Weight, diet, and physical activity-related beliefs and practices among pregnant and postpartum Latino women: the role of social support. Matern Child Health J. 2006;10(1):95–104.

    PubMed  Google Scholar 

  24. Borodulin K, Evenson K, Herring A. Physical activity patterns during pregnancy through postpartum. BMC Womens Health. 2009;9(32):1–7.

    Google Scholar 

  25. Zhang J, Savitz DA. Exercise during pregnancy among US women. Ann Epidemiol. 1996;6(1):53–9.

    PubMed  CAS  Google Scholar 

  26. Owe KM, Nystad W, Bø K. Correlates of regular exercise during pregnancy: the Norwegian mother and child cohort study. Scand J Med Sci Sports. 2009;19(5):637–45.

    PubMed  CAS  Google Scholar 

  27. Gaston A, Cramp A. Exercise during pregnancy: a review of patterns and determinants. J Sci Med Sport. 2011;14(4):299–305.

    PubMed  Google Scholar 

  28. Jukic AMZ, Evenson K, Herring A, Wilcox A, Hartmann K, Daniels J. Correlates of physical activity at two time points during pregnancy. J Phys Act Health. 2012;9(3):325–35.

    Google Scholar 

  29. Evenson K, Savitz D, Huston S. Leisure-time physical activity among pregnant U.S. women. Paediatr Perinat Epidemiol. 2004;18:400–7.

    PubMed  Google Scholar 

  30. Grace SL, Williams A, Stewart DE, Franche RL. Health-promoting behaviors through pregnancy, maternity leave, and return to work: effects of role spillover and other correlates. Women Health. 2006;43:51–72.

    PubMed  Google Scholar 

  31. Ning Y, Williams MA, Dempsey JC, Sorensen TK, Frederick IO, Luthy DA. Correlates of recreational physical activity in early pregnancy. J Matern Fetal Neonatal Med. 2003;13(6):385–93.

    PubMed  CAS  Google Scholar 

  32. Haakstad LA, Voldner N, Henriksen T, Bø K. Why do pregnant women stop exercising in the third trimester? Acta Obstet Gynecol Scand. 2009;88(11):1267–75.

    PubMed  Google Scholar 

  33. Cramp AG, Bray SR. Understanding leisure-time physical activity during pregnancy: a prospective examination of perceived barriers and self-efficacy. Ann Behav Med. 2009;37:325–34.

    PubMed  Google Scholar 

  34. Schmidt MD, Pekow P, Freedson PS, Markenson G, Chasan-Taber L. Physical activity patterns during pregnancy in a diverse population of women. J Womens Health. 2006;5(8):909–18.

    Google Scholar 

  35. Chasan-Taber L, Evenson KR, Sternfeld B, Kengeri S. Assessment of recreational physical activity during pregnancy in epidemiologic studies of birthweight and length of gestation: methodologic aspects. Women Health. 2007;45(4):85–107.

    PubMed  Google Scholar 

  36. Liu J, Blair S, Teng Y, Ness A, Lawlor D, Riddoch C. Physical activity during pregnancy in a prospective cohort of British women: results from the Avon longitudinal study of parents and children. Eur J Epidemiol. 2011;26(3):237–47.

    PubMed  Google Scholar 

  37. Lynch K, Landsbaugh J, Whitcomb B, Pekow P, Markenson G, Chasan Taber L. Physical activity of pregnant Hispanic women. Am J Prev Med. 2012;43(4):434–9.

    PubMed  Google Scholar 

  38. Blum JW, Beaudoin CM, Caton-Lemos L. Physical activity patterns and maternal well-being in postpartum women. Matern Child Health J. 2004;8:163–9.

    PubMed  Google Scholar 

  39. Hinton PS, Olson CM. Predictors of pregnancy-associated change in physical activity in a rural white population. Matern Child Health J. 2001;5(1):7–14.

    PubMed  CAS  Google Scholar 

  40. Evenson KR, Aytur SA, Borodulin K. Physical activity beliefs, barriers, and enablers among postpartum women. J Womens Health (Larchmt). 2009;18:1925–34.

    Google Scholar 

  41. Keller C, Allan J, Tinkle MB. Stages of change, processes of change, and social support for exercise and weight gain in postpartum women. J Obstet Gynecol Neonatal Nurs. 2006;35:232–40.

    PubMed  Google Scholar 

  42. Symons Downs D, Hausenblas H. Women’s exercise beliefs and behaviors during their pregnancy and postpartum. J Midwifery Womens Health. 2004;49:138–44.

    PubMed  Google Scholar 

  43. Doran F, Davis K. Factors that influence physical activity for pregnant and postpartum women and implications for primary care. Aust J Prim Health. 2011;17:79–85.

    PubMed  Google Scholar 

  44. Pereira M, Rifas-Shiman S, Kleinman K, Rich-Edwards J, Peterson K, Gillman M. Predictors of change in physical activity during and after pregnancy: Project Viva. Am J Prev Med. 2007;32:312–9.

    PubMed  Google Scholar 

  45. Symons Downs D, Ulbrecht JS. Understanding exercise beliefs and behaviors in women with gestational diabetes mellitus. Diabetes Care. 2006;29:236–40.

    PubMed  Google Scholar 

  46. Price SN, McDonald J, Oken E, Haines J, Gillman MW, Taveras EM. Content analysis of motivational counseling calls targeting obesity-related behaviors among postpartum women. Matern Child Health J. 2012;16:439–47.

    PubMed  Google Scholar 

  47. Smith BJ, Cheung NW, Bauman AE, Zehle K, McLean M. Postpartum physical activity and related psychosocial factors among women with recent gestational diabetes mellitus. Diabetes Care. 2005;28(11):2650–4.

    PubMed  Google Scholar 

  48. American Diabetes Association. Standards of medical care in diabetes – 2010. Diabetes Care. 2010;33:S11–61.

    Google Scholar 

  49. International Association of Diabetes and Pregnancy Study Groups Consensus Panel. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33:676–82.

    Google Scholar 

  50. Torloni MR, Betrán AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, Valente O. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev. 2009;10(2):194–203.

    PubMed  CAS  Google Scholar 

  51. Oteng Ntim E, Varma R, Croker H, Poston L, Doyle P. Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis. BMC Med. 2012;10:47.

    PubMed  Google Scholar 

  52. Cheung NW, Byth K. Population health significance of gestational diabetes. Diabetes Care. 2003;26(7):2005–9.

    PubMed  Google Scholar 

  53. Dabelea D, Snell-Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, McDuffie RS. Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado GDM Screening Program. Diabetes Care. 2005;28(3):579–84.

    PubMed  Google Scholar 

  54. Ferrara A, Kahn HS, Quesenberry CP, Riley C, Hedderson MM. An increase in the incidence of gestational diabetes mellitus: Northern California, 1991–2000. Obstet Gynecol. 2004;103(3):526–33.

    PubMed  Google Scholar 

  55. Guelinckx I, Devlieger R, Beckers K, Vansant G. Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obes Rev. 2008;9(2):140–50.

    PubMed  CAS  Google Scholar 

  56. O’Sullivan J. Diabetes mellitus after GDM. Diabetes. 1991;40 Suppl 2:131–5.

    PubMed  Google Scholar 

  57. Siega-Riz A, Viswanathan M, Moos M, Deierlein A, Mumford S, Knaack J, Thieda P, Kux LI, Lohr KN. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth, and postpartum weight retention. Obstet Gynecol. 2009;201(4):339.e1–14.

    Google Scholar 

  58. American Diabetes Association. Gestational diabetes mellitus. Diabetes Care. 2004;27 Suppl 1:S88–90.

    Google Scholar 

  59. Whitaker RC, Pepe MS, Seidel KD, Wright JA, Knopp RH. Gestational diabetes and the risk of offspring obesity. Pediatrics. 1998;101(2):E9.

    PubMed  CAS  Google Scholar 

  60. Oken E, Taveras EM, Kleinman KP, Rich-Edwards JW, Gillman MW. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol. 2007;196(4):322.e1–8.

    Google Scholar 

  61. Tobias D, Zhang C, van Dam R, Bowers K, Hu F. Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes Care. 2011;34(1):223–9.

    PubMed  Google Scholar 

  62. Han S, Middleton P, Crowther C. Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews (Internet) 2012 (Cited 17 Jan 2013) Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009021.

  63. Ong MJ, Guelfi KJ, Hunter T, Wallman KE, Fournier PA, Newnham JP. Supervised home-based exercise may attenuate the decline of glucose tolerance in obese pregnant women. Diabetes Metab. 2009;35(5):418–21.

    PubMed  CAS  Google Scholar 

  64. Callaway L, Colditz P, Byrne N, Lingwood B, Rowlands I, Groves A, Sansome X, O’Connor BR, Croaker S, Foxcroft K, McIntyre HD. Prevention of gestational diabetes: feasibility issues for an exercise intervention in obese pregnant women. Diabetes Care. 2010;33(7):1457.

    PubMed  Google Scholar 

  65. Roberts J, Pearson G, Cutler J, Lindheimer M. Summary of the NHLBI working group on research on hypertension during pregnancy. Hypertens Pregnancy. 2003;22(2):109–27.

    PubMed  Google Scholar 

  66. O’Brien T, Ray J, Chan W. Maternal body mass index and the risk of preeclampsia: a systematic overview. Epidemiology. 2003;14(3):368–74.

    PubMed  Google Scholar 

  67. Frederick I, Rudra C, Miller R, Foster J, Williams M. Adult weight change, weight cycling, and prepregnancy obesity in relation to risk of preeclampsia. Epidemiology. 2006;17(4):428–34.

    PubMed  Google Scholar 

  68. Villamor E, Cnattingius S. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet. 2006;368(9542):1164–70.

    PubMed  Google Scholar 

  69. Chang J, Elam-Evans LD, Berg CJ, Herndon J, Flowers L, Seed KA, Syverson CJ. Pregnancy-related mortality surveillance: United States, 1991—1999. MMWR Surveill Summ. 2003;52(SS02):1–8.

    PubMed  Google Scholar 

  70. Berg CJ, MacKay AP, Qin C, Callaghan WM. Overview of maternal morbidity during hospitalization for labour and delivery in the United States. Obstet Gynecol. 2009;113:1075–81.

    PubMed  Google Scholar 

  71. Kasawara K, Nascimento SLD, Costa M, Surita F, e Silva JLP. Exercise and physical activity in the prevention of pre-eclampsia: systematic review. Acta Obstet Gynecol Scand. 2012;91(10):1147–57.

    PubMed  Google Scholar 

  72. Yeo S, Davidge S, Ronis DL, Antonakos CL, Hayashi R, O’Leary S. A comparison of walking versus stretching exercises to reduce the incidence of preeclampsia: a randomized clinical trial. Hypertens Pregnancy. 2008;27(2):113–30.

    PubMed  Google Scholar 

  73. Hegaard H, Pedersen B, Nielsen B, Damm P. Leisure time physical activity during pregnancy and impact on gestational diabetes mellitus, pre-eclampsia, preterm delivery and birth weight: a review. Acta Obstet Gynecol Scand. 2007;86(11):1290.

    PubMed  Google Scholar 

  74. Østerdal ML, Strøm M, Klemmensen AK, Knudsen VK, Juhl M, Halldorsson TI, Nybo Andersen AM, Magnus P, Olsen SF. Does leisure time physical activity in early pregnancy protect against pre-eclampsia? Prospective cohort in Danish women. BJOG. 2009;116(1):98–107.

    PubMed  Google Scholar 

  75. Magnus P, Trogstad L, Owe K, Olsen S, Nystad W. Recreational physical activity and the risk of preeclampsia: a prospective cohort of Norwegian women. Am J Epidemiol. 2008;168(8):952–7.

    PubMed  Google Scholar 

  76. Rudra CB, Williams MA, Lee IM, Miller RS, Sorensen TK. Perceived exertion in physical activity and risk of gestational diabetes mellitus. Epidemiology. 2006;17(1):31–7.

    PubMed  Google Scholar 

  77. Weight gain during pregnancy: reexamining the guidelines. Washington (D.C.): Institute of Medicine and National Academy of Sciences; 2009.

    Google Scholar 

  78. Gore S, Brown D, West D. The role of postpartum weight retention in obesity among women: a review of the evidence. Ann Behav Med. 2003;26(2):149–59.

    PubMed  Google Scholar 

  79. Influence of pregnancy weight on maternal and child health. Washington (D.C.): National Research Council and Institute of Medicine; 2007. Workshop Report.

    Google Scholar 

  80. Bodnar L, Catov J, Klebanoff M, Ness R, Roberts J. Prepregnancy body mass index and the occurrence of severe hypertensive disorders of pregnancy. Epidemiology. 2007;18(2):234–9.

    PubMed  Google Scholar 

  81. Cedergren M. Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol. 2004;103(2):219–24.

    PubMed  Google Scholar 

  82. Crane JMG, White J, Murphy P, Burrage L, Hutchens D. The effect of gestational weight gain by body mass index on maternal and neonatal outcomes. J Obstet Gynaecol Can. 2009;31(1):28–35.

    PubMed  Google Scholar 

  83. Stuebe A, Oken E, Gillman M. Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain. Obstet Gynecol. 2009;201(1):58.e1–8.

    Google Scholar 

  84. Olson CM, Strawderman MS. Modifiable behavioral factors in a biopsychosocial model predict inadequate and excessive gestational weight gain. J Am Diet Assoc. 2003;103(1):48–54.

    PubMed  Google Scholar 

  85. Chasan-Taber L, Schmidt M, Pekow P, Sternfeld B, Solomon C, Markenson G. Predictors of excessive and inadequate gestational weight gain in Hispanic women. Obesity. 2008;16(7):1657–66.

    PubMed  Google Scholar 

  86. Sui Z, Grivell R, Dodd J. Antenatal exercise to improve outcomes in overweight or obese women: a systematic review. Acta Obstet Gynecol Scand. 2012;91(5):538–45.

    PubMed  Google Scholar 

  87. Kim C. Gestational diabetes: risks, management, and treatment options. Int J Womens Health. 2010;2:339–51.

    PubMed  CAS  Google Scholar 

  88. Lovelady CA, Garner KE, Moreno KL, Williams JP. The effect of weight loss in overweight, lactating women on the growth of their infants. N Engl J Med. 2000;342(7):449–53.

    PubMed  CAS  Google Scholar 

  89. O’Toole ML, Sawicki MA, Artal R. Structured diet and physical activity prevent postpartum weight retention. J Womens Health (Larchmt). 2003;12(10):991–8.

    Google Scholar 

  90. Lovelady CA, Nommsen Rivers LA, McCrory MA, Dewey KG. Effects of exercise on plasma lipids and metabolism of lactating women. Med Sci Sports Exerc. 1995;27(1):22–8.

    PubMed  CAS  Google Scholar 

  91. Ferrara A, Hedderson MM, Albright C, Ehrlich SF, Quesenberry CP, Peng T, Ching J, Cites Y. A pregnancy and postpartum lifestyle intervention in women with gestational diabetes mellitus reduces diabetes risk factors: a feasibility randomized control trial. Diabetes Care. 2011;34(7):1519–25.

    PubMed  Google Scholar 

  92. Leermakers EA, Anglin K, Wing RR. Reducing postpartum weight retention through a correspondence intervention. Int J Obes. 1998;22(11):1103–9.

    CAS  Google Scholar 

  93. Ostbye T, Krause K, Lovelady CA, Morey MC, Bastian LA, Peterson BL, Swamy GK, Brouwer RJ, McBride CM. Active mothers postpartum: a randomized controlled weight-loss intervention trial. Am J Prev Med. 2009;37(3):173–80.

    PubMed  Google Scholar 

  94. Kuhlmann AKS, Dietz P, Galavotti C, England L. Weight-management interventions for pregnant or postpartum women. Am J Prev Med. 2008;34(6):523–8.

    PubMed  Google Scholar 

  95. Bertz F, Brekke H, Ellegård L, Rasmussen K, Wennergren M, Winkvist A. Diet and exercise weight-loss trial in lactating overweight and obese women. Am J Clin Nutr. 2012;96(4):698–705.

    PubMed  CAS  Google Scholar 

  96. Evenson K, Chasan-Taber L, Symons Downs D, Pearce E. Review of self-reported physical activity assessments for pregnancy: summary of the evidence for validity and reliability. Paediatr Perinat Epidemiol. 2012;26:479–94.

    PubMed  Google Scholar 

  97. Connolly CP, Coe DP, Kendrick JM, Bassett DR, Thompson DL. Accuracy of physical activity monitors in pregnant women. Med Sci Sports Exerc. 2011;43(6):1100–5.

    PubMed  Google Scholar 

  98. Rousham E, Clarke P, Gross H. Significant changes in physical activity among pregnant women in the UK as assessed by accelerometry and self-reported activity. Eur J Clin Nutr. 2005;60(3):393–400.

    Google Scholar 

  99. McParlin C, Robson SC, Tennant PW, Besson H, Rankin J, Adamson AJ, Pearce MS, Bell R. Objectively measured physical activity during pregnancy: a study in obese and overweight women. BMC Pregnancy Childbirth. 2010;10:76.

    PubMed  Google Scholar 

  100. Doran F, O’Brien AP. A brief report of attitudes towards physical activity during pregnancy. Health Promot J Austr. 2007;18(2):155–8.

    PubMed  Google Scholar 

  101. Symons Downs D, Hausenblas HA. Exercising during pregnancy and postpartum: an elicitation study using the framework of the theory of planned behavior. J Midwifery Womens Health. 2004;49:138–44.

    PubMed  Google Scholar 

  102. Symons Downs D, Hausenblas HA. Elicitation studies and the theory of planned behavior: a systematic review of exercise beliefs. Psychol Sport Exerc. 2005;6:1–31.

    Google Scholar 

  103. Duncombe D, Wertheim EH, Skouteris H, Paxton SJ, Kelly L. How well do women adapt to changes in their body size and shape across the course of pregnancy? J Health Psychol. 2008;13:503–15.

    PubMed  Google Scholar 

  104. Lieferman J, Swibas T, Koiness K, Marshall JA, Dunn AL. My baby, my move: examination of perceived barriers and motivating factors related to antenatal physical activity. J Midwifery Womens Health. 2011;56(1):33–40.

    Google Scholar 

  105. Symons Downs D, Ulbrecht J. Exercise and gestational diabetes: an elicitation study based on the theory of planned behavior. Diabetes Care. 2006;29:236–40.

    PubMed  Google Scholar 

  106. Weir Z, Bush J, Robson SC, McParlin C, Rankin J, Bell R. Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women. BMC Pregnancy Childbirth. 2010;10:18. doi:10.1186/1471-2393-10-18.

    PubMed  Google Scholar 

  107. Pearce E, Evenson K, Symons Downs D, Steckler A. Strategies to promote physical activity during pregnancy: a systematic review. Am J Lifestyle Med. 2013;7(1):37–49.

    Google Scholar 

  108. Feinstein RA, Francis KT, Lorish C. Physical activity and fitness assessment. Ala Med. 1991;61(2):10–2, 14.

    PubMed  CAS  Google Scholar 

  109. Evenson KR, Pompeii LA. Obstetrician practice patterns and recommendations for physical activity during pregnancy. J Womens Health (Larchmt). 2010;19(9):1733–40.

    Google Scholar 

  110. Stotland NE, Gilbert P, Bogetz A, Harper CC, Abrams B, Gerbert B. Preventing excessive weight gain in pregnancy: how do prenatal care providers approach counseling? J Womens Health (Larchmt). 2010;19(4):807–14.

    Google Scholar 

  111. Stengel MR, Kraschnewski JL, Hwang SW, Kjerulff KH, Chuang CH. What my doctor didn’t tell me: examining health care provider advice to overweight and obese pregnant women on gestational weight gain and physical activity. Womens Health Issues. 2012;22(6):e535–40.

    PubMed  Google Scholar 

  112. Stotland N, Tsoh JY, Gerbert B. Prenatal weight gain: who is counseled? J Womens Health. 2012;21(6):695–701.

    Google Scholar 

  113. Symons Downs D, Savage JS, Rauff EL. Falling short of guidelines? Lacking knowledge to achieve gestational weight gain, diet, and physical activity recommendations in pregnancy. In review.

    Google Scholar 

  114. Meriwether RA, Lee JA, Lafleur AS, Wiseman P. Physical activity counseling. Am Fam Physician. 2008;77(8):1129–36.

    PubMed  Google Scholar 

  115. Jackson RA, Stotland NE, Caughey AB, Gerbert B. Improving diet and exercise in pregnancy with video doctor counseling: a randomized trial. Patient Educ Couns. 2011;83(2):203–9.

    PubMed  Google Scholar 

  116. Stotland N, Haas J, Brawarsky P, Jackson R, Fuentes Afflick E, Escobar G. Body mass index, provider advice, and target gestational weight gain. Obstet Gynecol. 2005;105(3):633–8.

    PubMed  Google Scholar 

  117. Stotland N, Cheng Y, Hopkins L, Caughey A. Gestational weight gain and adverse neonatal outcome among term infants. Obstet Gynecol. 2006;108(3):635–43.

    PubMed  Google Scholar 

  118. Cogswell ME, Scanlon KS, Fein SB, Schieve LA. Medically advised, mother’s personal target, and actual weight gain during pregnancy. Obstet Gynecol. 1999;94(4):616–22.

    PubMed  CAS  Google Scholar 

  119. Tovar A, Chasan-Taber L, Bermudez O, Hyatt R, Must A. Knowledge, attitudes, and beliefs regarding weight gain during pregnancy among Hispanic women. Matern Child Health J. 2010;14(6):938–49.

    PubMed  Google Scholar 

  120. Stotland N, Gilbert P, Bogetz A, Harper C, Abrams B, Gerbert B. Preventing excessive weight gain in pregnancy: how do prenatal care providers approach counseling? J Womens Health. 2010;19(4):807–14.

    Google Scholar 

  121. Merriam PA, Tellez TL, Rosal MC, Olendzki BC, Ma Y, Pagoto SL, Ockene IS. Methodology of a diabetes prevention translational research project utilizing a community-academic partnership for implementation in an underserved Latino community. BMC Med Res Methodol. 2009;9:20.

    PubMed  Google Scholar 

  122. King AC, Haskell WL, Taylor CB, Kraemer HC, DeBusk RF. Group- vs home-based exercise training in healthy older men and women. A community-based clinical trial. JAMA. 1991;266(11):1535–42.

    PubMed  CAS  Google Scholar 

  123. Oldridge NB. Compliance and exercise in primary and secondary prevention of coronary heart disease: a review. Prev Med. 1982;11(1):56–70.

    PubMed  CAS  Google Scholar 

  124. Marcus BH, Lewis BA, Williams DM, Dunsiger S, Jakicic JM, Whiteley JA, Albrecht AE, Napolitano MA, Brock BC, Tate DF, Sciamanna CN, Parisi AF. A comparison of internet and print-based physical activity interventions. Arch Intern Med. 2007;167(9):944–9.

    PubMed  Google Scholar 

  125. Cardinal BJ, Sachs ML. Effects of mail-mediated, stage-matched exercise behavior change strategies on female adults’ leisure-time exercise behavior. J Sports Med Phys Fitness. 1996;36(2):100–7.

    PubMed  CAS  Google Scholar 

  126. Chasan-Taber L, Marcus BH, Stanek E, Ciccolo JT, Marquez DX, Solomon CG, Markenson G. A randomized controlled trial of prenatal physical activity to prevent gestational diabetes: design and methods. J Womens Health (Larchmt). 2009;18(6):851–9.

    Google Scholar 

  127. Chasan-Taber L, Silveira M, Marcus B, Braun B, Stanek E, Markenson G. Feasibility and efficacy of a physical activity intervention among pregnant women: the behaviors affecting baby and you (B.A.B.Y.) study. J Phys Act Health. 2011;8 Suppl 2:S228–38.

    PubMed  Google Scholar 

  128. Chasan-Taber L, Hosker M, Marcus BH, Rosal MC, Braun B, Stanek E. Feasibility of a randomized trial to prevent gestational diabetes in overweight and obese hispanic women. BMC Pregnancy Childbirth. In review.

    Google Scholar 

  129. Symons Downs D, DiNallo JM, Rauff EL, Ulbrecht JS, Birch LL, Paul IM. Pregnant women’s exercise motivation and behavior: preliminary findings from a randomized physical activity intervention. Paper presented at the North American Society for the Psychology of Sport and Physical Activity, Tucson, AZ; 2010.

    Google Scholar 

  130. Symons Downs D. Determinants and outcomes of physical activity in pregnancy: findings from Active MOMS, a randomized physical activity intervention for pregnant women. Paper presented at The Society for Behavioral Medicine, Washington, DC; 2011.

    Google Scholar 

  131. Mottola MF, Giroux I, Gratton R, Hammond J, Hanley A, Harris S, McManus R, Davenport MH, Sopper MM. Nutrition and exercise prevent excess weight gain in overweight pregnant women. Med Sci Sports Exerc. 2010;42(2):265–72.

    PubMed  CAS  Google Scholar 

  132. Huang TT, Yeh CY, Tsai YC. A diet and physical activity intervention for preventing weight retention among Taiwanese childbearing women: a randomised controlled trial. Midwifery. 2011;27(2):257–64. doi:10.1016/j.midw.2009.06.009. Epub 2009 Sep 22.

    PubMed  Google Scholar 

  133. Kropp F, Winhusen T, Lewis D, Hague D, Somoza E. Increasing prenatal care and healthy behaviors in pregnant substance users. J Psychoactive Drugs. 2010;42(1):73–81.

    PubMed  Google Scholar 

  134. Hui A, Back L, Ludwig S, Gardiner P, Sevenhuysen G, Dean H, Sellers E, McGavock J, Morris M, Bruce S, Murray R, Shen GX. Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial. BJOG. 2012;119(1):70–7. doi:10.1111/j.1471-0528.2011.03184.x. Epub 2011 Oct 21.

    PubMed  CAS  Google Scholar 

  135. Luoto R, Kinnunen TI, Aittasalo M, Kolu P, Raitanen J, Ojala K, Mansikkamäki K, Lamberg S, Vasankari T, Komulainen T, Tulokas S. Primary prevention of gestational diabetes mellitus and large-for-gestational-age newborns by lifestyle counseling: a cluster-randomized controlled trial. PLoS Med. 2011;8(5):e1001036. doi:10.1371/journal.pmed.1001036. Epub 2011 May 17.

    PubMed  Google Scholar 

  136. Luoto RM, Kinnunen TI, Aittasalo M, Ojala K, Mansikkamäki K, Toropainen E, Kolu P, Vasankari T. Prevention of gestational diabetes: design of a cluster-randomized controlled trial and one-year follow-up. BMC Pregnancy Childbirth. 2010;10:39. doi:10.1186/1471-2393-10-39.

    PubMed  Google Scholar 

  137. Yeo S. Adherence to walking or stretching, and risk of preeclampsia in sedentary pregnant women. Res Nurs Health. 2009;32(4):379–90. doi:10.1002/nur.20328.

    PubMed  Google Scholar 

  138. Gaston A, Prapavessis H. Maternal-fetal disease information as a source of exercise motivation during pregnancy. Health Psychol. 2009;28(6):726–33.

    PubMed  Google Scholar 

  139. Petersen A, Leet T, Brownson R. Correlates of physical activity among pregnant women in the United States. Med Sci Sports Exerc. 2005;37:1748–53.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Kinesiology and OB/GYN, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA

    Danielle Symons Downs PhD

  2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Kelly R. Evenson PhD, MS

  3. Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA

    Lisa Chasan-Taber ScD

Authors
  1. Danielle Symons Downs PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kelly R. Evenson PhD, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lisa Chasan-Taber ScD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Danielle Symons Downs PhD .

Editor information

Editors and Affiliations

  1. Obstetrics & Gynecology, University of North Carolina, Chapel Hill, North Carolina, USA

    Wanda Nicholson

  2. School of Nursing, Pennsylvania State University, Hershey, Pennsylvania, USA

    Kesha Baptiste-Roberts

Appendix 9.1: Additional Reading Material

Appendix 9.1: Additional Reading Material

Another seven trials (Chasan-Taber et al. 2009;Ko 2008; Melo 2008; Newnham et al. 2011; Oostdam et al. 2009; Ramirez-Velez et al. 2009; Shen 2008) are ongoing and will be considered for inclusion in the next update of this review (see Characteristics of ongoing studies).

Chasan-Taber L, Marcus BH, Stanek 3rd E, Ciccolo JT, Marquez DX, Solomon CG, et al. A randomized controlled trial of prenatal physical activity to prevent gestational diabetes: design and methods. J Womens Health. 2009;18(6):851–9.

Ko CW. Effect of physical activity on metabolic syndrome in pregnancy and fetal outcome. ClinicalTrials.gov (http://clinicaltrials.gov/) (Accessed 9 Apr 2008).

Melo A. Exercise and pregnancy: randomised clinical trial. Current Controlled Trials (www.controlled-trials.com/) (Accessed 17 Mar 2010).

Newnham J. Fournier P. Guelfi K. Grove R. Wallman K. Doherty D. Preventing gestational diabetes mellitus using a home-based supervised exercise program during pregnancy. Exercise for pregnant women for preventing gestational diabetes mellitus (Review) 17. Copyright © 2012 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd. ClinicalTrials.gov (http://clinicaltrials.gov/), (Accessed 25 July 2011). (NCT01283854).

Oostdam N, Van Poppel MN, Eekhoff EM, Wouters MG, Van Mechelen W. Design of FitFor2 study: the effects of an exercise program on insulin sensitivity and plasma glucose levels in pregnant women at high risk for gestational diabetes. BMC Pregnancy Childbirth. 2009;9:1.

Ramirez-Velez R, Aguilar AC, Mosquera M, Garcia RG, Reyes LM, Lopez-Jaramillo P. Clinical trial to assess the effect of physical exercise on endothelial function and insulin resistance in pregnant women. Trials. 2009;10:104.

Shen G. Impact of diet and exercise activity on pregnancy outcomes (IDEA). ClinicalTrials.gov (http://clinicaltrials.gov/) (Accessed 20 Feb 2008).

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Downs, D.S., Evenson, K.R., Chasan-Taber, L. (2014). Obesity and Physical Activity During Pregnancy and Postpartum: Evidence, Guidelines, and Recommendations. In: Nicholson, W., Baptiste-Roberts, K. (eds) Obesity During Pregnancy in Clinical Practice. Springer, London. https://doi.org/10.1007/978-1-4471-2831-1_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-2831-1_9

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2830-4

  • Online ISBN: 978-1-4471-2831-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation