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Review of Recent Physical Activity Guidelines During Pregnancy to Facilitate Advice by Health Care Providers

Evenson, Kelly R. PhD, MS, FACSM*; Mottola, Michelle F. PhD, FACSM; Artal, Raul MD, FACSM, FACOG

Obstetrical & Gynecological Survey: August 2019 - Volume 74 - Issue 8 - p 481–489
doi: 10.1097/OGX.0000000000000693

Importance Physical activity during pregnancy can offer many maternal and fetal health benefits.

Objective The aim was to summarize American, Canadian, and international recommendations published recently on physical activity during pregnancy to aid health care providers in their delivery of advice on the topic.

Evidence Acquisition A descriptive review of 3 national guidelines and 1 international guideline on physical activity during pregnancy was conducted. The guidelines included the 2019 Canadian recommendations, the 2018 United States' Physical Activity Guidelines for Americans (second edition), the 2015 (reaffirmed in 2017) American College of Obstetrics and Gynecology guideline, and the 2016–2018 International Olympic Committee recommendations for recreational and elite athletes.

Results For apparently healthy women, under the guidance of their health care provider, moderate-intensity physical activity using both aerobic and muscle conditioning activities is recommended. The guidelines recommended at least 150 min/wk spread throughout the week (Canada, United States) or at least 20 to 30 min/d (American College of Obstetrics and Gynecology).

Conclusions and Relevance This summary of 4 recent guidelines can facilitate use of updated recommendations by health care providers regarding physical activity during pregnancy. More detailed evidence-based guidelines on physical activity during postpartum are needed.

Target Audience Obstetricians and gynecologists, family physicians

Learning Objectives After completing this activity, the learner should be better able to describe the most recent recommendations for physical activity during pregnancy; explain the relative and absolute contraindications to physical activity during pregnancy; and identify the warning signs for pregnant women to stop physical activity.

*Professor, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, NC

Director, R. Samuel McLaughlin Foundation–Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine, and Scientist, Children's Health Research Institute, University of Western Ontario, London, Ontario, Canada

Professor and Chairman Emeritus, Obstetrics and Gynecology and Women's Health, Saint Louis University, St Louis, MO

All authors, faculty, and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity.

Sources of Funding: K.R.E. was supported by a cooperative agreement from the Centers for Disease Control and Prevention (CDC; U50CCU422096) to the North Carolina Center for Birth Defects Research and Prevention. M.F.M. was funded by the Canadian Institute of Health Research Knowledge Synthesis Grant (grant 140995). The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC or the Canadian Institute of Health Research.

Correspondence requests to: Kelly R. Evenson, PhD, MS, FACSM, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 123 W Franklin St, Bldg C, Suite 410, Chapel Hill, NC 27599. E-mail:

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