Review
Exercise during pregnancy: A review of patterns and determinants

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Abstract

The mental and physical health benefits of exercise during pregnancy highlight the importance of understanding the determinants of pregnant women's physical activity. This paper presents a review of the existing research on pregnancy and physical activity, in order to (a) summarize the existing body of literature since 1986 examining changes in physical activity during pregnancy, (b) summarize correlates and predictors of physical activity during pregnancy, and (c) present directions for future research. A literature search yielded 25 articles published from 1986 to 2009 in English peer-reviewed journals. The major findings were categorized into the following: (a) exercise patterns, (b) demographic correlates/predictors, (c) the influence of pre-pregnancy exercise on pregnancy exercise, (d) theory-based predictors and (f) other correlates of exercise (e.g. general health and safety concerns). Results indicated that pregnant women are less active than non-pregnant women and that pregnancy leads to a decrease in physical activity. Consistent demographic predictors of higher exercise participation during pregnancy include higher education and income, not having other children in the home, being white, and being more active prior to becoming pregnancy. Only a few studies used theoretical models to understand physical activity during pregnancy with varied results. The review outlines demographic and theory-based correlates/predictors that should be taken into consideration when developing interventions to increase physical activity among pregnant women.

Introduction

Despite the numerous physical and mental health benefits associated with regular exercise,1, 2 many people fail to engage in a sufficient amount of exercise.3 Although numerous factors such as pursuing higher education and entering the workforce can disrupt or interfere with regular exercise,4 pregnancy has been associated with the sharp decline in exercise among adult women.5, 6, 7 Pregnancy is a time of social, psychological, behavioral and biological change.8 As such, it is not surprising that it has been identified as a contributing factor to the decline in exercise behavior among women.

Inactivity during pregnancy is cause for concern because prenatal women who do not engage in exercise forgo numerous health benefits. For example, exercise during pregnancy is associated with reduced risk of preeclampsia,9, 10, 11 gestational diabetes9, 12, 13 and preterm birth,9, 14 as well as improved pain tolerance, lower total weight gain and less fat mass gain, and improved self-image.15 For these reasons, US exercise guidelines recommend that all healthy women should get at least 150 min of moderate-intensity aerobic activity a week during pregnancy.16

In a recent review of 31 pregnancy and exercise studies, Poudevigne and O’Connor concluded that as pregnancy progresses, exercise levels decrease.17 Furthermore, the authors pointed out that the causes of exercise change during pregnancy appear to be numerous and complex. The purpose of the current study is to extend Poudevigne and O’Connor's work and review the existing literature to examine changes in exercise during pregnancy as well as identify correlates and predictors associated with changes in exercise and discuss avenues for future research.

Section snippets

Method

Inclusion criteria for this review are as follows: (a) studies had to include more than one assessment of exercise during pregnancy in order to assess change in exercise, (b) studies had to examine the relationship of at least one independent variable (determinant) with exercise, (c) studies had to be published in English and (d) data had to come from independent datasets (i.e., each study analyzed a unique dataset). Studies were excluded if they measured exercise but did not include any

Results

Data retrieved from the studies were categorized into the following result headings: (1) changes in exercise patterns, (2) demographic predictors of exercise during pregnancy, (3) the role of pre-pregnancy exercise, (4) theory-based predictors and (5) other correlates of exercise. Not all studies addressed all the headings and no other headings were identified. The findings for each heading are synthesized and presented concurrently.

Sixteen studies examined women's exercise during pregnancy.

Discussion

The focus of this review was to examine changes in exercise from pre-pregnancy to pregnancy and summarize the literature examining correlates and predictors of exercise during pregnancy. Consistent with Poudevigne and O’Connor,17 our results indicated that exercise decreases in frequency and intensity from pre-pregnancy to pregnancy and that few pregnant women are meeting exercise guidelines. While the relationship between exercise and a variety of demographic variables was examined, only a few

Conclusion

Given the positive physical and mental health outcomes associated with participating in regular exercise, promoting exercise during pregnancy needs to remain a crucial objective among health promoters. However, even among the general population, engaging in regular exercise is a complex and challenging behavior. Being pregnant presents further challenges to an already difficult behavior. This review summarizes the literature on exercise during pregnancy and presents some suggestions about when

Practical implications

  • Despite the benefits of exercise during pregnancy, many women are not sufficiently active. Health professionals who interact with pregnant women need to remain aware of the importance of exercise promotion.

  • Factors associated with a higher risk for inactivity include lower education and income, having other children in the home, and not being white. Health educators need to be aware of these risk factors in order to tailor their messages more effectively.

  • Women who are active prior to pregnancy

Acknowledgments

None. The authors received no external financial support to aid with the writing of this review.

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