5.10Exercise in pregnancy

What exercises are of benefit during pregnancy?
StudyRef.PopulationInterventionOutcomesResultsCommentsStudy typeEL
Kramer, 200210110 RCTs, 688 pregnant womenRegular aerobic exercise (at least 2 to 3 times/week) vs. reduction in frequency or intensity of such exerciseMaternal physical fitness
Pregnancy outcome
Self-perceived body image
5 trials (n = 171) report significant improvement in physical fitness in the exercise group but difference in measures prevents meta-analysis of results; 2 trials (n = 36) reported no significant increase in fitness in the exercise group
Gestational age (3 RCTs, n = 416): WMD 0.02, 95% CI −0.4, 0.4
Preterm birth (3 RCTs, n = 421): RR 2.29, 95% CI 1.02, 5.13
Birthweight (5 RCTs, n = 476): WMD 28.64, 95% CI −65.85 to 123.13
Pre-eclampsia (2 RCTs, n = 81): RR 1.17, 95% CI 0.44 to 3.08
Body image (1 RCT, n = 15):
Physical stamina, WMD −1.7, 95% CI −3.49 to 0.03
Muscular strength, WMD −2.2, 95% CI −3.62 to −0.72
Energy level, WMD −2.2, 95% CI −3.29 to −1.06
Body build, WMD −1.5, 95% CI −2.51 to −0.39
Trials either did not specify method of allocation or alternatedSR1a
What exercises are associated with adverse maternal and perinatal outcomes?
StudyRef.PopulationInterventionOutcomesResultsCommentsStudy typeEL
Camporesi, 1996102Three cross-sectional studies:
Study 1, 100 women who dived during pregnancy and n = 69 who did not
Study 2, 72 women who dived during pregnancy
Study 3, 142 dived pregnancies (i.e., some women dived during more than one pregnancy)
Retrospective questionnairesMalformations, SGA and other infant outcomes
Fetal decompression disease
Overall: fetus is at greater risk of malformations and embolisation after decompression bubbles evolve in circulation, owing to lack of pulmonary filtration and inability to resolve gas bubbles in alveoli
Study 1: none among non-diving mothers; 7/100 (7%) mothers had babies with congenital abnormalities
1.4% of babies were SGA in non-diving group; 6% in diving group
Raised incidence of miscarriage, stillbirth and neonatal death also reported.
Study 2: no evidence of increased risk to unborn fetus in mothers who stopped diving during the first trimester and mothers who dived throughout pregnancy
Study 3: n = 109 (75%) live births and n = 33 (23%) stillbirths or spontaneous miscarriages, evenly divided among dived pregnancies and non-dived pregnancies
Response rate of 169/208 (81%) in one study and the 72 from the second study were self-selected and from an initial 610 women
Third study fails to mention the outcome of 4 births
RCSS3

From: Evidence tables

Cover of Antenatal Care
Antenatal Care: Routine Care for the Healthy Pregnant Woman.
NICE Clinical Guidelines, No. 62.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2008 Mar.
Copyright © 2008, National Collaborating Centre for Women’s and Children’s Health.

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