Pregnant women face many obstacles to getting the exercise they require during gestation; yet there is ample evidence showing prenatal exercise can significantly improve both maternal and neonatal outcomes.
Women who exercised throughout their pregnancy had a lower relative risk of cesarean delivery due to its anti-inflammatory effect, according to research published by University College London. This effect can be explained as exercise helping decrease inflammation.
Physical Activity
Women who exercise are less likely to gain excess weight during gestation, experience gestational diabetes or preeclampsia complications and find it easier to shed extra pounds post-pregnancy. Physical activity also benefits the unborn fetus by helping keep heart rates lower and strengthening cardiovascular systems – while decreasing chronic diseases in adulthood.
Regular physical activity is an easy and cost-effective way to promote both mother and fetus health during pregnancy. The World Health Organization recommends 150 minutes of moderate intensity PA each week for adults; pregnant women without medical contraindications should participate in PA of similar duration and intensity.
But too often women do not engage in enough physical activity, and gynecologists may be unclear about which exercises to recommend to their patients. A study by McGee et al found that obstetricians’ beliefs and advice regarding exercise did not align with guidelines from the American Congress of Obstetricians and Gynecologists.
Weight Gain
Women who gain too much weight during gestation increase their risks of cesarean section and gestational diabetes as well as having poor birth outcomes such as macrosomia or low birthweight infants. Excessive gestational weight gain (EGWG) also has serious long-term implications for both mother and infant.
CPWCS-PUMC was carried out from 2017-2018 in 24 hospitals – consisting of secondary grades and above, maternal child health care centers, and general hospitals – located across 15 provinces. Anthropometric data was collected using standard sphygmomanometers by physicians assessing pregnant mothers’ heights, weights, blood pressure and abnormalities of foetuses with each visit to each hospital. Presiding physicians recorded any adverse pregnancy outcomes, complications or abnormalities of foetus at each visit visit as well.
Pregnant women were divided into groups based on their baseline BMI and GWG in each trimester of gestation, then further classified by their quartile of GWG: underweight group, normal weight group, overweight/obese group and obese group.
Preeclampsia
Preeclampsia is one of the most frequent and serious complications of pregnancy. It affects the arteries that provide blood and nutrients to the placenta, leading to insufficient supplies of oxygen and nutrition reaching it for proper fetal development and growth restriction in infants born. This can result in smaller babies (fetal growth restriction) as well as kidney, liver and blood clotting issues; pulmonary edema (fluid on lungs); seizures or in extreme cases even maternal death if left untreated.
Gestational hypertensive disorders affect up to 10% of pregnancies worldwide and are one of the primary causes of maternal and perinatal morbidity and mortality. Their hallmark – protein in urine above certain thresholds – defines preeclampsia. Theories regarding its origin vary, though most agree it begins when hormone balance disrupts, leading to abnormalities of small blood vessels throughout the body and creating preeclampsia symptoms in mother.
Cesarean Delivery
Women gestating while overweight and obese (OWOB) face higher risks of cesarean delivery, preterm birth and high-birth weight infants. Exercise appears to lower these risk factors; however, its precise physiological mechanisms remain unknown.
Observational studies have uncovered numerous confounding factors and heterogeneity across studies that make inference of causation impossible. However, significant associations can be summarized using numbers needed to treat (NNT) to represent both benefits and harms associated with birthing modes, providing women with advice regarding optimal methods. Trial of labor has been linked with decreased rates of urinary incontinence and pelvic organ prolapse; while repeat cesareans are linked with an increased risk of future pregnancy complications like maternal morbidity as well as long-term adverse childhood outcomes such as obesity and hypertension. This information could assist women when considering all options available to them based on observational studies that adjust for variables like age, parity, BMI maternal health status and gestational age.
