Recommendation
- 1.
All women without
Regular physical activity across the lifespan is associated with substantial health benefits including improvements in physical fitness and mental health, as well as decreased risk of chronic disease and mortality.1 Pregnancy is a unique period of a woman's life in which lifestyle behaviours, including physical activity, can significantly affect her health as well as that of her fetus.2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 Although guidelines around the world recommend women without
This 2019 Canadian Guideline for Physical Activity Throughout Pregnancy were developed according to the methodological strategy outlined in the AGREE II instrument.20 The goal of this guideline was to provide evidence-based recommendations regarding physical activity during pregnancy in the promotion of maternal, fetal, and neonatal health. The Guidelines Consensus Panel consisted of researchers in the field of prenatal exercise; methodological experts (AGREE II, GRADE; statistician, and
This guideline is intended for women who do not have contraindications (Table 2) that would prevent them from engaging in physical activity. Women with absolute contraindications may continue the usual activities of daily living but should not participate in more strenuous exercise. Women with relative contraindications should discuss the advantages and disadvantages of moderate-to-vigorous intensity physical activity with their obstetric care provider.
Recommendation All women without
Recommendations Pregnant women should accumulate at least 150 minutes of moderate-intensity physical activity each week to achieve clinically meaningful 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 (strong recommendation, moderate quality evidence). Pregnant women should incorporate a variety of aerobic exercise and resistance
The following guidance is based on the expert opinion of the Guidelines Consensus Panel.
Previously inactive women are encouraged to start physical activity in pregnancy but may need to begin gradually, at lower intensity, and increase the duration and intensity as their pregnancy progresses. It is important to note that when dose-response relationships between physical activity and pregnancy outcomes were identified, more physical activity (frequency, intensity, duration, and volume) was associated with greater health benefits. However, an upper limit was not established.
It may be
The Physical Activity Readiness Medical Examination for Pregnancy (PARmed-X for Pregnancy) was developed by CSEP and endorsed by SOGC and Health Canada (and available in English, French and Spanish through CSEP's website: http://www.csep.ca/view.asp?ccid=517) as an aid for health care providers and exercise professionals to identify contraindications for pregnant women prior to their participation in physical activity.40
The 2019 Canadian Guideline for Physical Activity Throughout Pregnancy represent a foundational shift in our view of prenatal physical activity from a recommended behaviour to improve quality of life to a specific prescription for physical activity to reduce pregnancy complications and optimize health across the lifespan of 2 generations. It is critical that these guidelines be implemented into clinical practice to achieve the significant and potentially lifelong health benefits for both mother
This work is funded by a Knowledge Synthesis Grant from the Canadian Institutes of Health Research. Dr. Davenport is funded by an Advancing Women's Heart Health Initiative New Investigator Award supported by Health Canada and the Heart and Stroke Foundation of Canada.
The following organizations have reviewed this document and endorse the Joint SOGC/CSEP Canadian Guidelines for Physical Activity throughout Pregnancy:• Alberta Health Services – Healthy Families and Children • Canadian Academy of Sports Medicine • Canadian Association of Midwives • College of Family Physicians of Canada • Directorate for Chief Medical Officer and Chief Scientist Office of Scotland • Exercise is Medicine Canada • Ontario Public Health Association • ParticipACTION • Perinatal Services BC • Sociedad Espanola de Ginecologia y Obstetricia (The Spanish Society of Gynecology and Obstetrics)
This article is being co-published in the British Journal of Sports Medicine (Mottola MF, Davenport MH, Ruchat S-M, et al. Br J Sports Med 2018;52:1339–1346. https://doi.org/10.1136/bjsports-2018-100056). This document reflects emerging clinical and scientific advances on the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well-documented if modified at the local level. None of these contents may be reproduced in any form without prior written permission of the publisher.
Women have the right and responsibility to make informed decisions about their care in partnership with their health care providers. In order to facilitate informed choice, women should be provided with information and support that is evidence based, culturally appropriate, and tailored to their needs. The values, beliefs, and individual needs of each woman and their family should be sought, and the final decision about the care and treatment options chosen by the woman should be respected.
*Denotes joint first authorship