In the latest recommendations issued by the American College of Obstetricians and Gynecologists (ACOG) on November 23, 2015, pregnant women with non-abnormal pregnancy are encouraged to actively participate in aerobic and strength physical exercises, including running, riding exercise bikes, and improved yoga.
Even pregnant women who do not move before pregnancy should start their exercise during pregnancy and gradually increase their exercise volume after consulting a physician. Professor Raul Artal, Honorary President of the Department of Obstetrics and Gynecology, St. Louis University, USA, stated in the statement that pregnancy should not be regarded as a state of imprisonment. In fact, because pregnant women have access to medical services and supervision more than other periods of life. Therefore, pregnancy is the ideal time to change lifestyle.
In this consensus on obstetric practice, the ACOG committee outlined various safe and unsafe exercise behaviors during and after pregnancy, updated the recommendations issued in 2002 and revisited the 2009 recommendations. .
This latest version of the recommendation is different from the 2002 version. Previously, ACOG only recommended appropriate exercise for pregnant women who were amateur or competitive athletes before pregnancy. And even in this case, it is recommended that pregnant women adjust their usual exercise habits according to medical guidance and avoid strenuous exercise in the middle and late pregnancy, especially for pregnant women with a history of preterm birth or fetal growth restriction. For pregnant women who do not exercise regularly before pregnancy, it is recommended that they consult a physician before starting any exercise program. (Obstet Gynecol 2002; 99: 171-3)
ACOG's new recommendations suggest that we now encourage pregnant women to participate in a certain number of physical activities during pregnancy, but before developing a specific exercise plan, physicians should conduct a thorough clinical evaluation to ensure that pregnant women do not have medical conditions that require exercise to avoid exercise.
The new version of the recommendation suggests that the target for pregnant women should be set to 20-30 minutes of moderate-intensity exercise every day or several times a week. The “talk test†ensures that the exercise intensity is not too intense by observing whether the pregnant woman can continue the conversation during exercise.
In the new recommendations, ACOG also specifies walking, swimming, riding exercise bikes, low-intensity aerobics, improved yoga or pilates, running, jogging, racket sports, and strength training for relatively safe exercise during pregnancy. However, pregnant women should avoid contact sports, diving, skydiving, hot yoga or high temperature pilates, as well as falling high-risk sports such as gymnastics and skiing. In addition, absolute contraindications for aerobic exercise during pregnancy include heart disease with hemodynamic disorders, restrictive lung disease, cervical sinus relaxation or cervical cerclage, and multiple pregnancy. (Obstet Gynecol. 2015;126:e135-42)
Pregnancy obesity
At the same time, ACOG also issued a clinical management guideline for pregnancy obesity, calling on gynaecologists to calculate the body mass index during the patient's first prenatal visit, and to give diet and exercise guidance.
This guide recommends that obese women lose weight before pregnancy (even if only a small weight loss) can improve pregnancy outcomes, and weight loss during pregnancy can help reduce the risk of obese pregnant women greater than gestational age. (Obstet Gynecol 2015;126:e112-26)
ACOG also recommends that clinicians consider extending the first stage of obesity in women before cesarean section surgery is planned to stop stagnation. In addition, obese pregnant women should be treated with antithrombotic therapy before and after cesarean section.
Although the stillbirth rate of obese pregnant women is higher than that of the general population, ACOG does not provide advice on whether obese pregnant women should undergo routine prenatal fetal monitoring because there is insufficient evidence that prenatal fetal monitoring can improve pregnancy outcomes.
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