Exercise in pregnancy and the postpartum period.
OBJECTIVE
To design Canadian guidelines advising obstetric care providers of the maternal, fetal, and neonatal implications of aerobic and strength-conditioning exercises in pregnancy.


RESULTS
Knowledge of the impact of exercise on maternal, fetal, and neonatal morbidity, and of the maternal measures of fitness.


METHODS
MEDLINE search from 1966 to 2002 for English-language articles related to studies of maternal aerobic and strength conditioning in a previously sedentary population, maternal aerobic and strength conditioning in a previously active population, impact of aerobic and strength conditioning on early and late pregnancy outcomes, and impact of aerobic and strength conditioning on neonatal outcomes, as well as for review articles and meta-analyses related to exercise in pregnancy.


METHODS
The evidence collected was reviewed by the Society of Obstetricians and Gynaecologists of Canada (SOGC Clinical Practice Obstetrics Committee) with representation from the Canadian Society for Exercise Physiology, and quantified using the evaluation of evidence guidelines developed by the Canadian Task Force on the Periodic Health Exam.


CONCLUSIONS
1. All women without contraindications should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy. (II-1,2B) 2. Reasonable goals of aerobic conditioning in pregnancy should be to maintain a good fitness level throughout pregnancy without trying to reach peak fitness or train for an athletic competition. (II-1,2C) 3. Women should choose activities that will minimize the risk of loss of balance and fetal trauma. (III-C) 4. Women should be advised that adverse pregnancy or neonatal outcomes are not increased for exercising women. (II-1,2B) 5. Initiation of pelvic floor exercises in the immediate postpartum period may reduce the risk of future urinary incontinence. (II-1C) 6. Women should be advised that moderate exercise during lactation does not affect the quantity or composition of breast milk or impact infant growth. (I-A) VALIDATION: This guideline has been approved by the SOGC Clinical Practice Obstetrics Committee, the Executive and Council of SOGC, and the Board of Directors of the Canadian Society for Exercise Physiology.


BACKGROUND
This guideline has been jointly sponsored by the Society of Obstetricians and Gynaecologists of Canada and the Canadian Society for Exercise Physiology.
Davies
Gregory A L
GA
Wolfe
Larry A
LA
Mottola
Michelle F
MF
MacKinnon
Catherine
C
Arsenault
Marc-Yvon
MY
Bartellas
Elias
E
Cargill
Yvonne
Y
Gleason
Tom
T
Iglesias
Stuart
S
Klein
Michael
M
Martel
Marie-Jocelyne
MJ
Roggensack
Anne
A
Wilson
Kathi
K
Gardiner
Philip
P
Graham
Terry
T
Haennel
Robert
R
Hughson
Richard
R
MacDougall
Duncan
D
McDermott
John
J
Ross
Robert
R
Tiidus
Peter
P
Trudeau
François
F
D000328:Adult; D002170:Canada; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007774:Lactation / Q000502:physiology; D016239:MEDLINE; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy / Q000502:physiology*; D011256:Pregnancy Outcome