Skip to main content
SpringerLink
Log in

Exercise Testing and Prescription in Pregnancy

  • Chapter
  • First Online:
Exercise and Physical Activity During Pregnancy and Postpartum

Abstract

Physical exercise should be part of an active lifestyle during pregnancy and the puerperium, as shown by growing evidence on its benefits for the health of pregnant women and newborns. Appropriate exercise testing and exercise prescription are needed to tailor effective and safe exercise programs. Exercise testing and prescription in pregnancy is the plan of exercise and fitness-related activities designed to meet the health and fitness goals and motivations of the pregnant woman. It should address the health-related fitness components and the pregnancy-specific conditions, based on previous health and exercise assessments, and take into account the body adaptations and the pregnancy-related symptoms of each stage of pregnancy, in order to provide safe and effective exercise. This chapter reviews the guidelines for exercise testing and prescription of pregnant women to be developed by exercise professionals, following the health screening and medical clearance for exercise by healthcare providers.

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 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover 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

Notes

  1. 1.

    Neuromotor exercise training involves motor skills such as balance, coordination, gait, and agility, and proprioceptive training and is sometimes called functional fitness training [2].

  2. 2.

    Cardiorespiratory fitness is the ability to perform large-muscle, whole-body exercise at moderate-to-vigorous intensities for extended periods of time [4].

  3. 3.

    Musculoskeletal fitness is the integrated function of muscle strength, muscle endurance, and muscle power to enable performance of work [4].

  4. 4.

    Flexibility is the range of motion available at a joint or group of joints [4].

  5. 5.

    Balance is the ability to maintain equilibrium while moving or while stationary [4].

  6. 6.

    Speed is the ability to move the body quickly [4].

  7. 7.

    Measurements in beats per minute (beats/min) or (bpm).

  8. 8.

    Measurements in mmHg.

  9. 9.

    Measure of highest rate of oxygen consumption during an exercise test regardless of whether or not a VO2 plateau is reached.

  10. 10.

    Usually, the volume is considered to be the product of intensity, frequency and duration of the exercise sessions.

  11. 11.

    With pregnant clients, the “progression” is assumed as the adaptation of exercise to each trimester of pregnancy, rather than focused on intensity and complexity, taking into account the physiological adaptations to pregnancy.

  12. 12.

    Outdoor cycling may be safe but requires regular participation prior to pregnancy. As any other activity, it requires balance and ability, depending on the purpose of use (e.g., sports, fitness, well-being, commuting), as well as appropriate equipment (i.e., there are several types of bikes). On the contrary, the Canadian guidelines are quite conservative regarding cycling [16].

References

  1. Suleman A, Heffner KD. Exercise prescription. Medscape, 2016. https://emedicine.medscape.com/article/88648-overview#a1. Accessed 3 Sep 2021.

  2. ACSM - American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. 11th ed. Philadelphia, PA: Wolters Kluwer Health; 2021.

    Google Scholar 

  3. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. USDHHS - U.S. Department of Health and Human Services. Physical activity guidelines for Americans. 2nd ed. Washington, DC: U.S. Department of Health and Human Services; 2018.

    Google Scholar 

  5. Szumilewicz A, Worska A, Santos-Rocha R, Oviedo-Caro MA. Evidence-based and practice-oriented guidelines for exercising during pregnancy. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 7.

    Google Scholar 

  6. WHO - World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020.

    Google Scholar 

  7. Artal R. Exercise during pregnancy and the postpartum period. UpToDate®. Philadelphia, PA: Wolters Kluwer; 2021. www.uptodate.com. Accessed 3 Sep 2021.

    Google Scholar 

  8. Dipietro L, Evenson KR, Bloodgood B, Sprow K, Troiano RP, Piercy KL, Vaux-Bjerke A, Powell KE, 2018 Physical Activity Guidelines Advisory Committee*. Benefits of physical activity during pregnancy and postpartum: an umbrella review. Med Sci Sports Exerc. 2019;51(6):1292–302.

    PubMed  PubMed Central  Google Scholar 

  9. Borodulin K, Evenson KR, Herring AH. Physical activity patterns during pregnancy through postpartum. BMC Womens Health. 2009;9:32.

    PubMed  PubMed Central  Google Scholar 

  10. Sjögren Forss K, Stjernberg L. Physical activity patterns among women and men during pregnancy and 8 months postpartum compared to pre-pregnancy: a longitudinal study. Front Public Health. 2019;7:294.

    PubMed  PubMed Central  Google Scholar 

  11. Krans EE, Gearhart JG, Dubbert PM, Klar PM, Miller AL, Replogle WH. Pregnant women’s beliefs and influences regarding exercise during pregnancy. J Miss State Med Assoc. 2005;46(3):67–73.

    PubMed  Google Scholar 

  12. RANZCOG - The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Exercise in pregnancy. Melbourne, VIC: RANZCOG; 2020.

    Google Scholar 

  13. NHS - National Health Service. Exercise in pregnancy exercise in pregnancy. London: National Health Service; 2020. www.nhs.uk.

    Google Scholar 

  14. EuropeActive. EuropeActive standards - European qualification framework level 5 - pregnancy and postnatal exercise specialist. 2016. http://www.ehfa-standards.eu/es-standards. Accessed 30 Dec 2017. Updated in 2022: https://www.europeactive-standards.eu/sites/europeactive-standards.eu/files/EuropeActive_Summary_Pregnancy-Postpartum-2022_0.pdf.

  15. Atkinson L, Teychenne M. Psychological, social and behavioural changes during pregnancy: implications for physical activity and exercise. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. Evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 2.

    Google Scholar 

  16. Mottola MF, Davenport MH, Ruchat S-M, Davies GA, Poitras VJ, Gray CE, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018;52(21):1339–46.

    PubMed  Google Scholar 

  17. AGDH - Australian Government. Department of Health. Guidelines for physical activity during pregnancy. Guidelines for physical activity during pregnancy (health.gov.au). Indianapolis, IN: Australian Government. Department of Health; 2021.

    Google Scholar 

  18. ACOG - American College of Obstetricians and Gynecologists. ACOG Committee opinion no. 804: Physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol. 2020;135(4):e178–e88.

    Google Scholar 

  19. SMA. Pregnancy and exercise. Women in sport. Sydney Olympic Park, NSW: SMA. SMA_AWiS_Pregnancy_Exercise.pdf. Sport Medicine Australia. Accessed 13 Jul 2021.

    Google Scholar 

  20. Bø K, Artal R, Barakat R, Brown WJ, Davies GAL, Dooley M, et al. Exercise and pregnancy in recreational and elite athletes: 2016/2017 evidence summary from the IOC expert group meeting, Lausanne. Part 5. Recommendations for health professionals and active women. Br J Sports Med. 2018;52(17):1080–5.

    PubMed  Google Scholar 

  21. ACSM - American College of Sport Medicine. ACSM information on pregnancy physical activity. Indianapolis, IN: American College of Sports Medicine; 2020. https://www.acsm.org/docs/currentcomments/exerciseduringpregnancy.pdf. Accessed 3 Sep 2021.

    Google Scholar 

  22. EIM/ACSM. Being active during pregnancy. Indianapolis, IN: Exercise is Medicine/American College of Sports Medicine; 2019.

    Google Scholar 

  23. ACOG - American College of Obstetricians and Gynecologists. Exercise during pregnancy and the postnatal period. Washington DC: American College of Obstetricians and Gynecologists; 1985.

    Google Scholar 

  24. ACOG - American College of Obstetricians and Gynecologists. Exercise during pregnancy and the postpartum period. ACOG Technical Bulletin, Number 189--February 1994. Int J Gynaecol Obstet. 1994;45(1):65–70.

    Google Scholar 

  25. ACOG - American College of Obstetricians and Gynecologists. ACOG Committee Opinion. Exercise during pregnancy and the postpartum period. Number 267, January 2002. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 2002;77(1):79–81.

    Google Scholar 

  26. Evenson KR, Barakat R, Brown WJ, et al. Guidelines for physical activity during pregnancy: comparisons from around the world. Am J Lifestyle Med. 2013;XX(X):1–20.

    Google Scholar 

  27. Szumilewicz A, Worska A, Rajkowska N, Santos-Rocha R. Summary of guidelines for exercise in pregnancy – are they comprehensive enough for designing the contents of a prenatal exercise program? Curr Women’s Health Rev. 2015;11(1):3–12.

    Google Scholar 

  28. ACOG - American College of Obstetricians and Gynecologists. Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 650. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2015;126:e135–42.

    Google Scholar 

  29. Bø K, Artal R, Barakat R, Brown W, Davies GA, Dooley M, Evenson KR, Haakstad LA, Henriksson-Larsen K, Kayser B, Kinnunen TI, Mottola MF, Nygaard I, van Poppel M, Stuge B, Khan KM. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1-exercise in women planning pregnancy and those who are pregnant. Br J Sports Med. 2016;50(10):571–89.

    PubMed  Google Scholar 

  30. Bø K, Artal R, Barakat R, Brown W, Dooley M, Evenson KR, Haakstad LA, Larsen K, Kayser B, Kinnunen TI, Mottola MF, Nygaard I, van Poppel M, Stuge B, Davies GA. IOC Medical Commission. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 2-the effect of exercise on the fetus, labour and birth. Br J Sports Med. 2016;50:1297.

    PubMed  Google Scholar 

  31. Bø K, Artal R, Barakat R, Brown WJ, Davies GAL, Dooley M, Evenson KR, Haakstad LAH, Kayser B, Kinnunen TI, Larsén K, Mottola MF, Nygaard I, van Poppel M, Stuge B, Khan KM. IOC Medical Commission. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3-exercise in the postpartum period. Br J Sports Med. 2017;51(21):1516–25.

    PubMed  Google Scholar 

  32. Bø K, Artal R, Barakat R, Brown WJ, Davies GAL, Dooley M, Evenson KR, Haakstad LAH, Kayser B, Kinnunen TI, Larsén K, Mottola MF, Nygaard I, van Poppel M, Stuge B, Khan KM. Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC expert group meeting, Lausanne. Part 4-Recommendations for future research. Br J Sports Med. 2017;51:1724.

    PubMed  Google Scholar 

  33. Kilpatrick SJ, Papile LA, Macones GA. Guidelines for perinatal care. 8th ed. Elk Grove Village, IL; Washington, DC: AAP Committee on Fetus and Newborn and ACOG Committee on Obstetric Practice; 2017. https://ebooks.aappublications.org/content/guidelines-for-perinatal-care-8th-edition.tab-info.

    Google Scholar 

  34. Barakat R, Perales M, Bacchi M, Coteron J, Refoyo I. A program of exercise throughout pregnancy. Is it safe to mother and newborn? Am J Health Promot. 2013;29(1):2–8.

    PubMed  Google Scholar 

  35. Perales M, Santos-Lozano A, Ruiz JR, Lucia A, Barakat R. Benefits of aerobic or resistance training during pregnancy on maternal health and perinatal outcomes: a systematic review. Early Hum Dev. 2016;94:43–8.

    PubMed  Google Scholar 

  36. Davenport MH, Skow RJ, Steinback CD. Maternal responses to aerobic exercise in pregnancy. Clin Obstet Gynecol. 2016;59(3):541–51.

    PubMed  Google Scholar 

  37. Morales-Suárez-Varela M, Clemente-Bosch E, Peraita-Costa I, Llopis-Morales A, Martínez I, Llopis-González A. Maternal physical activity during pregnancy and the effect on the mother and newborn: a systematic review. J Phys Act Health. 2020;18(1):130–47.

    PubMed  Google Scholar 

  38. Magro-Malosso ER, Saccone G, Di Tommaso M, Roman A, Berghella V. Exercise during pregnancy and risk of gestational hypertensive disorders: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2017;96(8):921–31.

    PubMed  Google Scholar 

  39. Magro-Malosso ER, Saccone G, Di Mascio D, Di Tommaso M, Berghella V. Exercise during pregnancy and risk of preterm birth in overweight and obese women: a systematic review and meta-analysis of randomized controlled trials. Acta Obstet Gynecol Scand. 2017;96(3):263–73.

    PubMed  Google Scholar 

  40. Harrison AL, Shields N, Taylor NF, Frawley HC. Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review. J Physiother. 2016;62(4):188–96.

    PubMed  Google Scholar 

  41. Daley AJ, Foster L, Long G, Palmer C, Robinson O, Walmsley H, Ward R. The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta-analysis. BJOG. 2015;122(1):57–62.

    CAS  PubMed  Google Scholar 

  42. Nakamura A, van der Waerden J, Melchior M, Bolze C, El-Khoury F, Pryor L. Physical activity during pregnancy and postpartum depression: systematic review and meta-analysis. J Affect Disord. 2019;246:29–41.

    PubMed  Google Scholar 

  43. Blaize AN, Pearson KJ, Newcomer SC. Impact of maternal exercise during pregnancy on offspring chronic disease susceptibility. Exerc Sport Sci Rev. 2015;43(4):198–203.

    PubMed  PubMed Central  Google Scholar 

  44. SMA - Sport Medicine Australia. SMA statement the benefits and risks of exercise during pregnancy. J Sci Med Sport. 2002;5(1):11–9.

    Google Scholar 

  45. CSEP - Canadian Society for Exercise Physiology. Get Active Questionnaire for PREGNANCY. Ottawa, ON: Canadian Society for Exercise Physiology; 2021. https://csep.ca/2021/01/20/pre-screening-forphysical-activity/#. Accessed 6 Aug 2022.

  46. PAR-Q+ Collaboration. Physical activity readiness questionnaire for everyone (PAR-Q+). 2017. http://eparmedx.com/. Accessed 9 Mar 2021.

  47. ACSM - American College of Sports Medicine. ACSM’s resources for the exercise physiologist. 2nd ed. Philadelphia, PA: Wolters Kluwer; 2018, 472 p.

    Google Scholar 

  48. ACSM - American College of Sports Medicine. ACSM’s resources manual for guidelines for exercise testing and prescription. 7th ed. Philadelphia, PA: Wolters Kluwer, Lippincott Williams & Wilkins; 2014, 862 p.

    Google Scholar 

  49. ACSM - American College of Sports Medicine. ACSM’s health status & health history questionnaire. Indianapolis, IN: ACSM. http://www.wm.edu/offices/wellness/campusrec/documents/fitnessquestionnaire.pdf. Accessed 3 Sep 2021.

  50. Kavanagh JJ, Menz HB. Accelerometry: a technique for quantifying movement patterns during walking. Gait Posture. 2008;28(1):1–15.

    PubMed  Google Scholar 

  51. Braakhuis HEM, Berger MAM, Bussmann JBJ. Effectiveness of healthcare interventions using objective feedback on physical activity: a systematic review and meta-analysis. J Rehabil Med. 2019;51(3):151–9.

    PubMed  Google Scholar 

  52. Tang MSS, Moore K, McGavigan A, Clark RA, Ganesan AN. Effectiveness of wearable trackers on physical activity in healthy adults: systematic review and meta-analysis of randomized controlled trials. JMIR Mhealth Uhealth. 2020;8(7):e15576.

    PubMed  PubMed Central  Google Scholar 

  53. Sallis JF, Haskell WL, Wood PD, Fortmann SP, Rogers T, Blair SN. Physical activity assessment methodology in the Five-City Project. Am J Epidemiol. 1985;121:91–106.

    CAS  PubMed  Google Scholar 

  54. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.

    PubMed  Google Scholar 

  55. Chasan-Taber L, Schmidt MD, Roberts DE, Hosmer D, Markenson G, Freedson PS. Development and validation of a pregnancy physical activity questionnaire. Med Sci Sports Exerc. 2004;36(10):1750–60.

    PubMed  Google Scholar 

  56. Foxcroft KF, Callaway LK, Byrne NM, Webster J. Development and validation of a pregnancy symptoms inventory. BMC Pregnan Childb. 2013;13:3.

    Google Scholar 

  57. Barakat R, Pelaez M, Montejo R, Luaces M, Zakynthinaki M. Exercise during pregnancy improves maternal health perception: a randomized controlled trial. Am J Obstet Gynecol. 2011;204(5):402.e401–7.

    Google Scholar 

  58. Smith R, Reid H, Matthews A, Calderwood C, Knight M, Foster C, CMO Physical Activity Expert Committee for Physical Activity and Pregnancy. Infographic: physical activity for pregnant women. Br J Sports Med. 2017;52:532. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/622335/CMO_physical_activity_pregnant_women_infographic.pdf. Accessed 3 Sep 2021.

    PubMed  Google Scholar 

  59. Kendall-Raynor P. Physical activity for pregnant women. Nurs Stand. 2017;31(46):15.

    PubMed  Google Scholar 

  60. ACOG - American College of Obstetricians and Gynecologists. Your pregnancy and childbirth. 7th ed. Washington, DC: American College of Obstetricians and Gynecologists; 2021.

    Google Scholar 

  61. Perales M, Nagpal TS, Barakat R. Physiological changes during pregnancy. Main adaptations and discomforts and implications for physical activity and exercise. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. Evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 3.

    Google Scholar 

  62. Pimenta N, van Poppel M. Body composition changes during pregnancy and effects of physical exercise. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. Evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 4.

    Google Scholar 

  63. Bø K, Stuge B, Hilde G. Specific musculoskeletal adaptations in pregnancy: pelvic floor, pelvic girdle and low back pain. Implications for physical activity and exercise. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. Evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 6.

    Google Scholar 

  64. Fitzgerald CM, Segal NA. Musculoskeletal health in pregnancy and postpartum. Cham: Springer International Publishing; 2015.

    Google Scholar 

  65. Branco M, Santos-Rocha R, Aguiar L, Vieira F, Veloso AP. Biomechanical adaptations of gait in pregnancy. Implications for physical activity and exercise. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. Evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 5.

    Google Scholar 

  66. Dennis AT, Salman M, Paxton E, Flint M, Leeton L, Roodt F, Yentis S, Dyer RA. Resting hemodynamics and response to exercise using the 6-minute walk test in late pregnancy: an international prospective multicentre study. Anesth Analg. 2019;129(2):450–7.

    CAS  PubMed  Google Scholar 

  67. Wowdzia JB, Davenport MH. Cardiopulmonary exercise testing during pregnancy. Birth Defects Res. 2021;113(3):248–64.

    CAS  PubMed  Google Scholar 

  68. O’Toole ML, Artal R. Clinical exercise testing during pregnancy and the postpartum period. In: Weisman IM, Zeballos RJ, editors. Clinical exercise testing (Progress in respiratory research), vol. 32. Basel: Karger; 2002. p. 273–81.

    Google Scholar 

  69. Wolfe LA. Pregnancy. In: Skinner JS, editor. Exercise testing and exercise prescription for special cases: theoretical basis and clinical application. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2005. p. 377–91.

    Google Scholar 

  70. Jędrzejko M, Nowosielski K, Poręba R, Ulman-Włodarz I, Bobiński R. Physical efficiency and activity energy expenditure in term pregnancy females measured during cardiopulmonary exercise tests with a supine cycle ergometer. J Matern Fetal Neonatal Med. 2016;29(23):3800–5.

    PubMed  Google Scholar 

  71. Mottola MF, Davenport MH, Brun CR, Inglis SD, Charlesworth S, Stopper MM. VO2peak prediction and exercise prescription for pregnant women. Med Sci Sports Exerc. 2006;38(8):1389–95.

    PubMed  Google Scholar 

  72. Tinius RA, Blankenship M, Maples JM, Pitts BC, Furgal K, Norris ES, Hoover DL, Olenick A, Lambert J, Cade WT. Validity of the 6-minute walk test and YMCA submaximal cycle test during midpregnancy. J Strength Cond Res. 2021;35(11):3236–42.

    PubMed  Google Scholar 

  73. Szumilewicz A, Dornowski M, Piernicka M, Worska A, Kuchta A, Kortas J, Błudnicka M, Radzimiński Ł, Jastrzębski Z. High-low impact exercise program including pelvic floor muscle exercises improves pelvic floor muscle function in healthy pregnant women – a randomized control trial. Front Physiol. 2019;9:1867.

    PubMed  PubMed Central  Google Scholar 

  74. Melzer K, Schutz Y, Boulvain M, Kayser B. Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Med. 2010;40(6):493–507.

    PubMed  Google Scholar 

  75. Rikli RE, Jones CJ. Senior fitness test manual. 2nd ed. Champaign, IL: Human Kinetics; 2013.

    Google Scholar 

  76. Rose DJ. Fallproof!: a comprehensive balance and mobility training program. 2nd ed. Champaign, IL: Human Kinetics; 2015.

    Google Scholar 

  77. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP, American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59.

    PubMed  Google Scholar 

  78. Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med. 2014;48(4):299–310.

    PubMed  Google Scholar 

  79. Miquelutti MA, Cecatti JG, Makuch MY. Developing strategies to be added to the protocol for antenatal care: an exercise and birth preparation program. Clinics. 2015;70(4):231–6.

    PubMed  PubMed Central  Google Scholar 

  80. Akca A, Corbacioglu Esmer A, Ozyurek ES, Aydin A, Korkmaz N, Gorgen H, Akbayir O. The influence of the systematic birth preparation program on childbirth satisfaction. Arch Gynecol Obstet. 2017;295(5):1127–33.

    PubMed  Google Scholar 

  81. van Poppel M, Owe KM, Santos-Rocha R, Dias H. Physical activity, exercise and health promotion for the pregnant exerciser and the pregnant athlete. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. Evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 1.

    Google Scholar 

  82. Troy KL, Mancuso ME, Butler TA, Johnson JE. Exercise early and often: effects of physical activity and exercise on women’s bone health. Int J Environ Res Public Health. 2018;15(5):878.

    PubMed Central  Google Scholar 

  83. Sañudo B, de Hoyo M, Del Pozo-Cruz J, Carrasco L, Del Pozo-Cruz B, Tejero S, Firth E. A systematic review of the exercise effect on bone health: the importance of assessing mechanical loading in perimenopausal and postmenopausal women. Menopause. 2017;24(10):1208–16.

    PubMed  Google Scholar 

  84. Boyle R, Hay-Smith EJ, Cody JD, Mørkved S. Pelvic floor muscle training for prevention and treatment of urinary and fecal incontinence in antenatal and postnatal women: a short version Cochrane review. Neurourol Urodyn. 2014;33(3):269–76.

    PubMed  Google Scholar 

  85. Guelfi KJ, Ong MJ, Crisp NA, Fournier PA, Wallman KE, Grove JR, Doherty DA, Newnham JP. Regular exercise to prevent the recurrence of gestational diabetes mellitus: a randomized controlled trial. Obstet Gynecol. 2016;128(4):819–27.

    PubMed  Google Scholar 

  86. Wang C, Wei Y, Zhang X, Zhang Y, Xu Q, Sun Y, Su S, Zhang L, Liu C, Feng Y, Shou C, Guelfi KJ, Newnham JP, Yang H. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women. Am J Obstet Gynecol. 2017;216(4):340–51.

    PubMed  Google Scholar 

  87. Andersen MB, Ovesen PG, Daugaard M, Ostenfeld EB, Fuglsang J. Cycling reduces blood glucose excursions after an oral glucose tolerance test in pregnant women: a randomized crossover trial. Appl Physiol Nutr Metab. 2020;45(11):1247–52.

    CAS  PubMed  Google Scholar 

  88. Petrov Fieril K, Glantz A, Fagevik Olsen M. The efficacy of moderate-to-vigorous resistance exercise during pregnancy: a randomized controlled trial. Acta Obstet Gynecol Scand. 2015;94(1):35–42.

    PubMed  Google Scholar 

  89. Barakat R, Perales M. Resistance exercise in pregnancy and outcome. Clin Obstet Gynecol. 2016;59(3):591–9.

    PubMed  Google Scholar 

  90. Keskin Y, Kilic G, Taspinar O, Posul SO, Halac G, Eren F, Erol E, Urkmez B, Aydin T. Effectiveness of home exercise in pregnant women with carpal tunnel syndrome: randomized control trial. J Pak Med Assoc. 2020;70(2):202–7.

    PubMed  Google Scholar 

  91. Mazzarino M, Kerr D, Wajswelner H, Morris ME. Pilates method for women’s health: systematic review of randomized controlled trials. Arch Phys Med Rehabil. 2015;96(12):2231–42.

    PubMed  Google Scholar 

  92. Rodríguez-Díaz L, Ruiz-Frutos C, Vázquez-Lara JM, Ramírez-Rodrigo J, Villaverde-Gutiérrez C, Torres-Luque G. Effectiveness of a physical activity programme based on the Pilates method in pregnancy and labour. Enferm Clin. 2017;27(5):271–7. English, Spanish.

    PubMed  Google Scholar 

  93. Hagen S, Glazener C, McClurg D, Macarthur C, Elders A, Herbison P, Wilson D, Toozs-Hobson P, Hemming C, Hay-Smith J, Collins M, Dickson S, Logan J. Pelvic floor muscle training for secondary prevention of pelvic organ prolapse (PREVPROL): a multicentre randomised controlled trial. Lancet. 2017;389(10067):393–402.

    PubMed  Google Scholar 

  94. Sonmezer E, Özköslü MA, Yosmaoğlu HB. The effects of clinical pilates exercises on functional disability, pain, quality of life and lumbopelvic stabilization in pregnant women with low back pain: a randomized controlled study. J Back Musculoskelet Rehabil. 2021;34(1):69–76.

    PubMed  Google Scholar 

  95. Gong H, Ni C, Shen X, Wu T, Jiang C. Yoga for prenatal depression: a systematic review and meta-analysis. BMC Psychiatry. 2015;15:14.

    PubMed  PubMed Central  Google Scholar 

  96. Sheffield KM, Woods-Giscombé CL. Efficacy, feasibility, and acceptability of perinatal yoga on women’s mental health and well-being: a systematic literature review. J Holist Nurs. 2016;34(1):64–79.

    PubMed  Google Scholar 

  97. Kwon R, Kasper K, London S, Haas DM. A systematic review: the effects of yoga on pregnancy. Eur J Obstet Gynecol Reprod Biol. 2020;250:171–7.

    PubMed  Google Scholar 

  98. Katz VL. Water exercise in pregnancy. Semin Perinatol. 1996;20(4):285–91.

    CAS  PubMed  Google Scholar 

  99. Waller B, Lambeck J, Daly D. Therapeutic aquatic exercise in the treatment of low back pain: a systematic review. Clin Rehabil. 2009;23(1):3–14.

    PubMed  Google Scholar 

  100. Rodríguez-Blanque R, Aguilar-Cordero MJ, Marín-Jiménez AE, Menor-Rodríguez MJ, Montiel-Troya M, Sánchez-García JC. Water exercise and quality of life in pregnancy: a randomised clinical trial. Int J Environ Res Public Health. 2020;17(4):1288.

    PubMed Central  Google Scholar 

  101. Jarski RW, Trippett DL. The risks and benefits of exercise during pregnancy. J Fam Pract. 1990;30(2):185–9.

    CAS  PubMed  Google Scholar 

  102. DeMaio M, Magann EF. Exercise and pregnancy. J Am Acad Orthop Surg. 2009;17(8):504–14.

    PubMed  Google Scholar 

  103. Juhl M, Kogevinas M, Andersen PK, Andersen AM, Olsen J. Is swimming during pregnancy a safe exercise? Epidemiology. 2010;21(2):253–8.

    PubMed  Google Scholar 

  104. Kramer MS, McDonald SW. Aerobic exercise for women during pregnancy. Cochrane Database Syst Rev. 2006;(3):CD000180.

    Google Scholar 

  105. Lamina S, Agbanusi E. Effect of aerobic exercise training on maternal weight gain in pregnancy: a meta-analysis of randomized controlled trials. Ethiop J Health Sci. 2013;23(1):59–64.

    CAS  PubMed  PubMed Central  Google Scholar 

  106. Sanders SG. Dancing through pregnancy: activity guidelines for professional and recreational dancers. J Dance Med Sci. 2008;12(1):17–22.

    PubMed  Google Scholar 

  107. Haakstad LA, Bø K. Exercise in pregnant women and birth weight: a randomized controlled trial. BMC Pregnan Childb. 2011;11:66.

    Google Scholar 

  108. Jorge C, Santos-Rocha R, Bento T. Can group exercise programs improve health outcomes in pregnant women? A systematic review. Curr Women’s Health Rev. 2015;11(1):75–87.

    Google Scholar 

  109. ASC - Australian Sports Commission. Pregnancy and sport: guidelines for the Australian sporting industry. Bruce, ACT: ASC; 2002.

    Google Scholar 

  110. Szymanski LM, Satin AJ. Strenuous exercise during pregnancy: is there a limit? Am J Obstet Gynecol. 2012;207(3):179.e1–6.

    Google Scholar 

  111. Pivarnik JM, Szymanski LM, Conway MR. The elite athlete and strenuous exercise in pregnancy. Clin Obstet Gynecol. 2016;59(3):613–9.

    PubMed  Google Scholar 

  112. Szumilewicz A, Santos-Rocha R. Exercise selection during pregnancy. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. Evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 9.

    Google Scholar 

  113. Gellish RL, Goslin BR, Olson RE, McDonald A, Russi GD, Moudgil VK. Longitudinal modeling of the relationship between age and maximal heart rate. Med Sci Sports Exerc. 2007;39(5):822–9.

    PubMed  Google Scholar 

  114. Centers for Disease Control and Prevention. Perceived exertion (Borg rating of perceived exertion scale). Atlanta, GA: CDC. http://www.cdc.gov/physicalactivity/basics/measuring/exertion.htm. Accessed 3 Sep 2021.

  115. Persinger R, Foster C, Gibson M, Fater DC, Porcari JP. Consistency of the talk test for exercise prescription. Med Sci Sports Exerc. 2004;36(9):1632–6.

    PubMed  Google Scholar 

  116. Tudor-Locke C, Hatano Y, Pangrazi RP, Kang M. Revisiting “how many steps are enough?”. Med Sci Sports Exerc. 2008;40(7 Suppl):S537–43.

    PubMed  Google Scholar 

  117. Mottola MF. Physical activity and maternal obesity: cardiovascular adaptations, exercise recommendations, and pregnancy outcomes. Nutr Rev. 2013;71(Suppl 1):S31–6.

    PubMed  Google Scholar 

  118. Santos-Rocha R. Ativo em Casa / Active at Home. YouTube Channel. https://www.youtube.com/channel/UCEUWdoBeh5rgfM0kZOn9Xtg/videos.

  119. Santos-Rocha R, Fernandes de Carvalho M, Prior de Freitas J. Gravidez Ativa - Active Pregnancy. YouTube Channel. https://www.youtube.com/channel/UC0Vyookwc0mcQ5T70imtoNA/playlists.

  120. Miquelutti MA, Cecatti JG, Makuch MY. Evaluation of a birth preparation program on lumbopelvic pain, urinary incontinence, anxiety and exercise: a randomized controlled trial. BMC Pregnan Childb. 2013;13:154.

    Google Scholar 

  121. Sichani LE, Bahadoran P, Fahami F, Esfahani PS. The investigation of effects of static immersion and calming in water on pregnant women’s stress participating in preparation classes for childbirth. J Educ Health Promot. 2019;8:238.

    PubMed  PubMed Central  Google Scholar 

  122. Sivan E, Homko CJ, Chen XH, Reece EA, Boden G. Effect of insulin on fat metabolism during and after normal pregnancy. Diabetes. 1999;48(4):834–8.

    CAS  PubMed  Google Scholar 

  123. Zhang CL, Ning Y. Effect of dietary and lifestyle factors on the risk of gestational diabetes: review of epidemiologic evidence. Am J Clin Nutr. 2011;94(6):1975S–9S.

    CAS  PubMed  PubMed Central  Google Scholar 

  124. Association AD. Standards of medical care in diabetes—2016. Diabetes Care. 2016;39(Suppl 1):S1–S106.

    Google Scholar 

  125. IDF. Diabetes atlas. 7th ed. Brussels: IDF; 2015.

    Google Scholar 

  126. Carolan-OIah MC. Educational and intervention programmes for gestational diabetes mellitus (GDM) management: an integrative review. Collegian. 2016;23:103–14.

    PubMed  Google Scholar 

  127. Pettit D, Bennett PH, Knowler WC, et al. Gestational diabetes mellitus and impaired glucose tolerance during pregnancy: long-term effects on obesity and glucose intolerance in the offspring. Diabetes Care. 1985;34:119–22.

    Google Scholar 

  128. Horvath K, Koch K, Jeitler K, et al. Effects of treatment in women with gestational diabetes mellitus: systematic review and meta-analysis. BMJ. 2010;340:1395.

    Google Scholar 

  129. Russo LM, Nobles C, Ertel KA, et al. Physical activity interventions in pregnancy and risk of gestational diabetes mellitus: a systematic review and meta-analysis. Obstet Gynecol. 2015;125:576–82.

    PubMed  Google Scholar 

  130. Brankston GN, Mitchell BF, Ryan EA, Okun NB. Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus. Am J Obstet Gynecol. 2004;190(1):188–93.

    CAS  PubMed  Google Scholar 

  131. Barakat R, Cordero Y, Coteron J, Luaces M, Montejo R. Exercise during pregnancy improves maternal glucose screen at 24-28 weeks: a randomised controlled trial. Br J Sports Med. 2012;46(9):656–61.

    PubMed  Google Scholar 

  132. Sanabria-Martínez G, García-Hermoso A, Poyatos-León R, Álvarez-Bueno C, Sánchez-López M, Martínez-Vizcaíno V. Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta-analysis. BJOG. 2015;122(9):1167–74.

    PubMed  Google Scholar 

  133. Bgeginski R, Ribeiro PAB, Mottola MF, Ramos JGL. Effects of weekly supervised exercise or physical activity counseling on fasting blood glucose in women diagnosed with gestational diabetes mellitus: a systematic review and meta-analysis of randomized trials. J Diabetes. 2017;9:1023–32.

    CAS  PubMed  Google Scholar 

  134. Brown J, Ceysens G, Boulvain M. Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes. Cochrane Database Syst Rev. 2017;6(6):CD012202.

    PubMed  Google Scholar 

  135. Shepherd E, Gomersall JC, Tieu J, Han S, Crowther CA, Middleton P. Combined diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Syst Rev. 2017;11(11):CD010443.

    PubMed  Google Scholar 

  136. Davenport MH, Ruchat SM, Poitras VJ, Jaramillo Garcia A, Gray CE, Barrowman N, Skow RJ, Meah VL, Riske L, Sobierajski F, James M, Kathol AJ, Nuspl M, Marchand AA, Nagpal TS, Slater LG, Weeks A, Adamo KB, Davies GA, Barakat R, Mottola MF. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med. 2018;52(21):1367–75.

    PubMed  Google Scholar 

  137. Ribeiro MM, Andrade A, Nunes I. Physical exercise in pregnancy: benefits, risks and prescription. J Perinat Med. 2021;50:4.

    PubMed  Google Scholar 

  138. Choi J, Fukuoka Y, Lee JH. The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: a systematic review and meta analysis of randomized controlled trials. Prev Med. 2013;56(6):351–64.

    PubMed  PubMed Central  Google Scholar 

  139. ACOG - American College of Obstetricians and Gynecologists. Obesity and pregnancy. ACOG Committee opinion No. 549. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2013;121:213–7.

    Google Scholar 

  140. Mottola MF, Giroux I, Gratton R, et al. Nutrition and exercise prevent excess weight gain in overweight pregnant women. Med Sci Sports Exerc. 2010;42(2):265–72.

    CAS  PubMed  PubMed Central  Google Scholar 

  141. Renault KM, Norgaard K, Nilas L, Carlsen EM, Cortes D, Pryds O, et al. The treatment of Obese Pregnant women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women. Am J Obstet Gynecol. 2014;210:134.e1–9.

    Google Scholar 

  142. International Weight Management in Pregnancy (i-WIP) Collaborative Group. Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. BMJ. 2017;358:j3119.

    Google Scholar 

  143. Ruchat SM, Mottola MF, Skow RJ, Nagpal TS, Meah VL, James M, Riske L, Sobierajski F, Kathol AJ, Marchand AA, Nuspl M, Weeks A, Gray CE, Poitras VJ, Jaramillo Garcia A, Barrowman N, Slater LG, Adamo KB, Davies GA, Barakat R, Davenport MH. 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):1347–56.

    PubMed  Google Scholar 

  144. Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.

    PubMed  Google Scholar 

  145. Gillon TE, Pels A, von Dadelszen P, et al. Hypertensive disorders of pregnancy: a systematic review of international clinical practice guidelines. PLoS One. 2014;9(12):e113715.

    PubMed  PubMed Central  Google Scholar 

  146. Berzan E, Doyle R, Brown CM. Treatment of preeclampsia: current approach and future perspectives. Curr Hypertens Rep. 2014;16(9):473.

    PubMed  Google Scholar 

  147. Djurisic S, Hviid TV. HLA class Ib molecules and immune cells in pregnancy and preeclampsia. Front Immunol. 2014;5:652.

    PubMed  PubMed Central  Google Scholar 

  148. Mparmpakas D, Goumenou A, Zachariades E, et al. Immune system function, stress, exercise and nutrition profile can affect pregnancy outcome: lessons from a Mediterranean cohort. Exp Ther Med. 2013;5(2):411–8.

    CAS  PubMed  Google Scholar 

  149. Chawla S, Anim-Nyame N. Advice on exercise for pregnant women with hypertensive disorders of pregnancy. Int J Gynaecol Obstet. 2015;128(3):275–9.

    PubMed  Google Scholar 

  150. Abu MA, Abdul Ghani NA, Lim Pei S, Sulaiman AS, Omar MH, Muhamad Ariffin MH, et al. Do exercises improve back pain in pregnancy? Horm Mol Biol Clin Invest. 2017;32(3):1–7.

    Google Scholar 

  151. Watelain E, Pinti A, Doya R, Garnier C, Toumi H, Boudet S. Benefits of physical activities centered on the trunk for pregnant women. Phys Sportsmed. 2017;45(3):293–302.

    PubMed  Google Scholar 

  152. Sklempe Kokic I, Ivanisevic M, Uremovic M, Kokic T, Pisot R, Simunic B. Effect of therapeutic exercises on pregnancy-related low back pain and pelvic girdle pain: secondary analysis of a randomized controlled trial. J Rehabil Med. 2017;49(3):251–7.

    PubMed  Google Scholar 

  153. Shiri R, Coggon D, Falah-Hassani K. Exercise for the prevention of low back and pelvic girdle pain in pregnancy: a meta-analysis of randomized controlled trials. Eur J Pain. 2018;22(1):19–27.

    CAS  PubMed  Google Scholar 

  154. Bishop A, Holden MA, Ogollah RO, Foster NE. Current management of pregnancy-related low back pain: a national cross-sectional survey of U.K. physiotherapists. Physiotherapy. 2016;102(1):78–85.

    CAS  PubMed  Google Scholar 

  155. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;(9):CD001139.

    Google Scholar 

  156. Davenport MH, Marchand AA, Mottola MF, Poitras VJ, Gray CE, Jaramillo Garcia A, Barrowman N, Sobierajski F, James M, Meah VL, Skow RJ, Riske L, Nuspl M, Nagpal TS, Courbalay A, Slater LG, Adamo KB, Davies GA, Barakat R, Ruchat SM. Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. Br J Sports Med. 2019;53(2):90–8.

    PubMed  Google Scholar 

  157. Ohman SG, Grunewald C, Waldenstrom U. Women’s worries during pregnancy: testing the Cambridge Worry Scale on 200 Swedish women. Scand J Caring Sci. 2003;17(2):148–52.

    PubMed  Google Scholar 

  158. Gavin N, Gaynes BN, Lohr KN, Meltzer-Brody S. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106(5):1071–83.

    PubMed  Google Scholar 

  159. Bennett HA, Einarsson A, Taddio A. Prevalence of depression during pregnancy: systematic review. Obstet Gynecol. 2006;103(4):698–709.

    Google Scholar 

  160. Trivedi MH, Greer TL, Grannemann BD, Chambliss HO, Jordan AN. Exercise as an augmentation strategy for treatment of major depression. J Psychiatr Pract. 2006;12:205–13.

    PubMed  Google Scholar 

  161. Padmapriya N, Bernard J, Liang S, Loy S, Shen Z, Kwek K, et al. Association of physical activity and sedentary behavior with depression and anxiety symptoms during pregnancy in a multiethnic cohort of Asian women. Archiv Women’s Ment Health. 2016;19(6):1119–28.

    Google Scholar 

  162. McCurdy AP, Boulé NG, Sivak A, Davenport MH. Effects of exercise on mild-to-moderate depressive symptoms in the postpartum period: a meta-analysis. Obstet Gynecol. 2017;129:1087.

    PubMed  Google Scholar 

  163. Davenport MH, McCurdy AP, Mottola MF, Skow RJ, Meah VL, Poitras VJ, Jaramillo Garcia A, Gray CE, Barrowman N, Riske L, Sobierajski F, James M, Nagpal T, Marchand AA, Nuspl M, Slater LG, Barakat R, Adamo KB, Davies GA, Ruchat SM. Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis. Br J Sports Med. 2018;52(21):1376–85.

    PubMed  Google Scholar 

  164. Davenport MH, Meyer S, Meah VL, Strynadka MC, Khurana R. Moms are not OK. COVID-19 and maternal mental health. Front Glob Women’s Health. 2020;1:1.

    Google Scholar 

  165. Gildner TE, Laugier EJ, Thayer ZM. Exercise routine change is associated with prenatal depression scores during the COVID-19 pandemic among pregnant women across the United States. PLoS One. 2020;15(12):1–15.

    Google Scholar 

  166. Atkinson L, De Vivo M, Hayes L, Hesketh KR, Mills H, Newham JJ, et al. Encouraging physical activity during and after pregnancy in the COVID-19 era, and beyond. Int J Environ Res Public Health. 2020;17(19):7304.

    PubMed Central  Google Scholar 

  167. Silva MRG, Rodriguez Doñate B, Che Carballo KN. Nutritional requirements for the pregnant exerciser and athlete. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. Evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 13.

    Google Scholar 

  168. Jorge R, Teixeira D, Ferreira I, Alvarez-Fálcon AL. Diet recommendations for the pregnant exerciser and athlete. In: Santos-Rocha R, editor. Exercise and physical activity during pregnancy and postpartum. Evidence-based guidelines. 2nd ed. Cham: Springer International Publishing; 2022. Chapter 14.

    Google Scholar 

  169. Institute of Medicine (US) and National Research Council (US) Committee to reexamine IOM pregnancy weight guidelines, Rasmussen KM, Yaktine AL. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academies Press; 2009. https://www.ncbi.nlm.nih.gov/books/NBK32813/. Accessed 15 Sep 2021.

    Google Scholar 

  170. Yang X, Zhang A, Sayer L, Bassett S, Woodward S. The effectiveness of group-based pelvic floor muscle training in preventing and treating urinary incontinence for antenatal and postnatal women: a systematic review. Int Urogynecol J. 2021;33:1407.

    PubMed  PubMed Central  Google Scholar 

  171. Woodley SJ, Lawrenson P, Boyle R, Cody JD, Mørkved S, Kernohan A, Hay-Smith EJC. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020;5(5):CD007471.

    PubMed  Google Scholar 

  172. American College of Sports Medicine, Sawka MN, Burke LM, et al. American College of Sports Medicine position stand. Exercise and fluid replacement. Med Sci Sports Exerc. 2007;39(2):377–90.

    Google Scholar 

  173. Schauberger CW, Rooney BL, Goldsmith L, Shenton D, Silva PD, Schaper A. Peripheral joint laxity increases in pregnancy but does not correlate with serum relaxin levels. Am J Obstet Gynecol. 1996;174(2):667–71.

    CAS  PubMed  Google Scholar 

  174. Dumas GA, Reid JG. Laxity of knee cruciate ligaments during pregnancy. J Orthop Sports Phys Therapy. 1997;26(1):2–6.

    CAS  Google Scholar 

  175. Ebi KL, Capon A, Berry P, Broderick C, de Dear R, Havenith G, Honda Y, Kovats RS, Ma W, Malik A, Morris NB, Nybo L, Seneviratne SI, Vanos J, Jay O. Hot weather and heat extremes: health risks. Lancet. 2021;398(10301):698–708.

    PubMed  Google Scholar 

  176. Dervis S, Dobson KL, Nagpal TS, Geurts C, Haman F, Adamo KB. Heat loss responses at rest and during exercise in pregnancy: a scoping review. J Therm Biol. 2021;99:103011.

    PubMed  Google Scholar 

  177. Branco M, Santos-Rocha R, Vieira F. Biomechanics of gait during pregnancy. Sci World J. 2014;2014:527940.

    Google Scholar 

  178. Gimunová M, Zvonař M, Sebera M, Turčínek P, Kolářová K. Special footwear designed for pregnant women and its effect on kinematic gait parameters during pregnancy and postpartum period. PLoS One. 2020;15(5):e0232901.

    PubMed  PubMed Central  Google Scholar 

  179. Petrov Fieril K, Fagevik Olsén M, Glantz A, Larsson M. Experiences of exercise during pregnancy among women who perform regular resistance training: a qualitative study. Phys Ther. 2014;94(8):1135–43.

    PubMed  Google Scholar 

  180. Harrison CL, Brown WJ, Hayman M, Moran LJ, Redman LM. The role of physical activity in preconception, pregnancy and postpartum health. Semin Reprod Med. 2016;34(2):e28–37.

    PubMed  PubMed Central  Google Scholar 

  181. Díaz-Burrueco JR, Cano-Ibáñez N, Martín-Peláez S, Khan KS, Amezcua-Prieto C. Effects on the maternal-fetal health outcomes of various physical activity types in healthy pregnant women. A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2021;262:203–15.

    PubMed  Google Scholar 

  182. Kehler AK, Heinrich KM. A selective review of prenatal exercise guidelines since the 1950s until present: written for women, health care professionals, and female athletes. Women Birth. 2015;28(4):e93–8.

    PubMed  PubMed Central  Google Scholar 

  183. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. Int J Nurs Stud. 2013;50(5):587–92.

    PubMed  Google Scholar 

  184. Möhler R, Köpke S, Meyer G. Criteria for reporting the development and evaluation of complex interventions in healthcare: revised guideline (CReDECI 2). Trials. 2015;16:204.

    PubMed  PubMed Central  Google Scholar 

  185. Slade SC, Dionne CE, Underwood M, Buchbinder R. Consensus on exercise reporting template (CERT): explanation and elaboration statement. Br J Sports Med. 2016;50:1428–37.

    PubMed  Google Scholar 

  186. Santos-Rocha R, Fernandes de Carvalho M, Szumilewicz A. Active pregnancy - a physical exercise program aimed at promoting health and fitness during pregnancy. Development and validation of a complex intervention. Int J Environ Res Public Health. 2022;19:4902.

    CAS  PubMed  PubMed Central  Google Scholar 

  187. Biviji R, Williams KS, Vest JR, Dixon BE, Cullen T, Harle CA. Consumer perspectives on maternal and infant health apps: qualitative content analysis. J Med Internet Res. 2021;23(9):e27403.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Sport Sciences School of Rio Maior - ESDRM, Polytechnic Institute of Santarém, Rio Maior, Portugal

    Rita Santos-Rocha

  2. Laboratory of Biomechanics and Functional Morphology, Interdisciplinary Centre for the Study of Human Performance - CIPER, Faculty of Human Kinetics - FMH, University of Lisbon, Lisbon, Portugal

    Rita Santos-Rocha

  3. Fetal Medicine Unit, Department of Surgery, University Hospital Virgen Macarena, University of Seville, Seville, Spain

    Isabel Corrales Gutiérrez

  4. Gdansk University of Physical Education and Sport, Gdańsk, Poland

    Anna Szumilewicz

  5. Lithuanian Sports University, Kaunas, Lithuania

    Simona Pajaujiene

Authors
  1. Rita Santos-Rocha
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Isabel Corrales Gutiérrez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna Szumilewicz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Simona Pajaujiene
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rita Santos-Rocha .

Editor information

Editors and Affiliations

  1. Sport Sciences School of Rio Maior - ESDRM, Polytechnic Institute of Santarém, Rio Maior, Portugal

    Rita Santos-Rocha

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Santos-Rocha, R., Corrales Gutiérrez, I., Szumilewicz, A., Pajaujiene, S. (2022). Exercise Testing and Prescription in Pregnancy. In: Santos-Rocha, R. (eds) Exercise and Physical Activity During Pregnancy and Postpartum. Springer, Cham. https://doi.org/10.1007/978-3-031-06137-0_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-06137-0_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-06136-3

  • Online ISBN: 978-3-031-06137-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation