Exercise offers many benefits during pregnancy

Aug 3 2009

Physicians should recommend low to moderate levels of exercise to their pregnant patients, even if they have not exercised prior to pregnancy, states a report published in the August 2009 issue of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS).

According to this review article, exercise can strengthen and improve overall musculoskeletal and physiologic health as well as pregnancy related symptoms. Exercise such as aerobics, impact and nonimpact activities, resistance training and swimming:

• eases back and other musculoskeletal pain;
• lowers maternal blood pressure;
• reduces swelling; and
• improves post-partum mood, including sadness.

According to study author Capt. Marlene DeMaio, M.D., M.C ., U.S.N., Research Director, Naval Medical Center, Portsmouth, Virginia, data shows that the pregnant woman's body can compensate for the changes with no harm to the fetus during low to moderate intensity exercise.

"It is important to remember that pregnancy is a temporary condition, not a disease, and that the musculoskeletal and physiologic changes that happen are normal in the majority of patients," she said.

Capt. DeMaio's findings contradict what some physicians recommended in the past. As recently as the 1990s, there was concern that exercise could be detrimental to a pregnant woman and her fetus. These past concerns included a focus on normal changes related to musculoskeletal health that occur during pregnancy, such as increased ligament laxity, weight gain and change in the center of gravity. Today, some physicians continue to advise their pregnant patients to ease back on exercise or refrain from it altogether if they have not already made it a part of their lifestyle.

DeMaio, who collaborated with Capt. Everett Magann, M.D., M.C. U.S.N., Chairman in the Department of Obstetrics and Gynecology, also at the Naval Medical Center in Portsmouth, not only reports that exercise is important during pregnancy, but also believes that starting an exercise program when pregnant, is a perfect way to begin - and stick with - a fitness program.

"When a woman becomes pregnant, she often re-evaluates her lifestyle," said Dr. DeMaio. "She is motivated in a new way to deliver a healthy baby, and be healthy herself." Physicians may recommend exercise for pregnant patients in the following categories:

• Prenatal: Patients should begin or continue low to moderate exercise. The goal is to maintain fitness and adapt exercise as needed as pregnancy progresses. (For example, runners might switch to running in a swimming pool later in their pregnancy.)
• Postnatal: Continue exercising at low to moderate levels. Lactation is not negatively affected by exercise. There are fewer reports of mothers having post-partum depression or mood changes when they are exercising.
• Older: Exercise is even more important if the patient is older, according to Dr. DeMaio. The risk for high blood pressure and increased glucose goes up the older a patient is, but exercise can help reduce these levels.
• Obese: Physicians should discuss pregnancy as an opportunity to improve overall health and suggest the patient start exercise for life-long health and as an example to the child when the child is older.
• Infertile: Even if a woman is under treatment for infertility, she can exercise under the supervision of her obstetrician.
• Athlete: For a pregnant woman wanting more strenuous exercise, or who wants to increase training from moderate to high intensity, a qualified doctor should direct her exercise program.

www.jaaos.org and www.aaos.org