Canadian guideline: All women without contraindication should be physically active throughout pregnancy
Interested in the benefits, indications and contraindications for physical activity throughout pregnancy? Please read this guideline and follow the link.
Strong recommendations are summarized below:
All women without contraindication should be physically active throughout pregnancy. moderate-quality evidence.
- Women who were previously inactive. moderate-quality evidence.
- Women categorised as overweight or obese (prepregnancy body mass index ≥25 kg/m2). low-quality evidence.
- Pregnant women should accumulate at least 150 min of moderate-intensityiii physical activity each week to achieve clinically meaningful health benefits and reductions in pregnancy complications. Strong recommendation, moderate-quality evidence.
- Physical activity should be accumulated over a minimum of 3 days per week; however, being active every day is encouraged. moderate-quality evidence.
- Pregnant women should incorporate a variety of aerobic and resistance training activities to achieve greater benefits. Adding yoga and/or gentle stretching may also be beneficial. high-quality evidence.
More than half of pregnant women are on sick leave during pregnancy, most frequently reported cause is lumbopelvic pain. Facilitating job adjustments and exercise gym may prevent sick leave in late pregnancy
‘Facilitating job adjustments when required might keep more pregnant women in employment. Furthermore, pain locations in pelvic area, disability, lower education and being sick listed due to LPP in mid pregnancy are important risk factors for sick leave in late pregnancy.’
Running during pregnancy: higher rates assisted vaginal deliveries, no affect on gestational age or birthweight centile
‘Continuing to run during pregnancy does not appear to affect gestational age or birthweight centile, regardless of mean weekly distance or stage of pregnancy. Assisted vaginal delivery rates were higher in women who ran, possibly due to increased pelvic floor muscle tone. Randomised prospective analysis is necessary to further explore these findings’
‘Elastic tape decreases pain in pregnancy-related pelvic girdle pain. Pelvic girdle pain deteriorates the quality of life for pregnant women.’
‘The incidence of LBPs and pelvic girdle pains was high and found to be 34.3% and 57.6%, respectively. Analgesics were used especially among those with severe pains. There was an incidental finding of urinary incontinence among pregnant women with complaints of low back/pelvic girdle pains. There was no statistically significant association between LBPs and maternal BMI.
‘The popularity of Web-based discussion forums among pregnant women suggests that this group needs additional sources of information and support to complement traditional consultations with the health professionals. The professionals need to recognize that pregnant women access Web-based discussion forums for support and information to increase their ability to take better health decisions for themselves. This is a potential resource that health professionals may find useful in consultations with pregnant women.’
PLBP/PGP needs to be addressed early in pregnancy to reduce both individual suffering and risk of chronicity
‘Most women did not report any sick leave or sought any healthcare due to PLBP/PGP the past 6 months at Q3. However, women with ‘continuous’ PLBP/PGP 14 months postpartum did report a higher prevalence and degree of sick leave and sought healthcare to a higher extent compared to women with ‘recurrent’ PLBP/PGP at Q3. Women with more pronounced symptoms might constitute a specific subgroup of patients with a less favourable long-term outcome, thus PLBP/PGP needs to be addressed early in pregnancy to reduce both individual suffering and the risk of transition into chronicity.’
Assessment of pain in the lumbopelvic area early in pregnancy and postpartum necessary to identify women with risk of long term pain
‘This unique long-term follow up of PGP highlights the importance of assessment of pain in the lumbopelvic area early in pregnancy and postpartum in order to identify women with risk of long term pain. One of 10 women with PGP in pregnancy has severe consequences up to 11 years later. They could be identified by number of positive pain provocation tests and experience of previous LBP. Access to evidence based treatments are important for individual and socioeconomic reasons.’
Self-reported PGP, pain locations and clinical tests at GW30 do not lead to unfavourable clinical course postpartum
‘PGP prevalence remained unchanged from 12 weeks to one year postpartum (31-30%). Physical functioning (PF) and bodily pain(BP) scores improved markedly from Gravity Week 30 to 12 weeks postpartum, and marginally thereafter. The most afflicted women at GW30 experienced largest improvement.’ ‘PF and BP scores improved markedly from GW30 to 12 weeks postpartum, and marginally thereafter. Despite high PGP prevalence one year postpartum, most women recovered in terms of PF and BP scores. Unfavourable clinical course postpartum did not appear to depend on self-reported PGP, pain locations in the pelvis, or response to clinical tests at GW30.’
pain location combined with responses to P4 and ASLR tests are relevant when evaluating affliction in pregnant women with possible PGP
‘The objective of this cross-sectional study was to explore the associations between pain locations, responses to the posterior pelvic pain provocation (P4) test, responses to the active straight leg raise (ASLR) test and disability in late pregnancy. 283 women in gestation week 30 (mean age 31.3 years; 59% nullipara) completed a questionnaire (including pain drawing and Disability Rating Index, DRI). Women with PGP were more afflicted than the women with LBP and those without PGP. Highest DRI score was reported by women having combined symphysis pain and bilateral posterior pain. The multivariate analyses showed that results from P4 and ASLR contributed independently to DRI. Taken together, pain location combined with responses to P4 and ASLR tests are relevant when evaluating affliction in pregnant women with possible PGP.’