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Hormones

, Volume 17, Issue 4, pp 521–529 | Cite as

Guidelines for exercise during normal pregnancy and gestational diabetes: a review of international recommendations

  • Dimitra Savvaki
  • Eleftheria Taousani
  • Dimitrios G. Goulis
  • Efrosini Tsirou
  • Evangelia Voziki
  • Helen Douda
  • Nikolaos Nikolettos
  • Savvas P. Tokmakidis
Original Article

Abstract

Objective

Τo summarize and present the main guidelines for exercise during normal pregnancy and pregnancy complicated by gestational diabetes mellitus (GDM).

Methods

Relevant guidelines were retrieved through the electronic databases PubMed (MEDLINE), CENTRAL (Cochrane), and Embase; reference sections of the retrieved publications; proceedings of the main congresses in the field; and websites of relevant organizations published during the years 2000–2018.

Results

All guidelines recommend aerobic training from 60 to 150 min/week, with an upper limit of 30 min/day. Exercise is safe, even on a daily basis. Resistance exercise is suggested by five national guidelines (Australia, Canada, Denmark, Norway, and the UK). Discrepancies exist regarding the recommended intensity of exercise. Canada, Japan, Spain, and the UK use both objective (heart rate and maximum oxygen consumption) and subjective criteria (Borg’s Scale and talk test) to determine the effectiveness and safety of exercise. Only Canada provides specific recommendations, according to the woman’s age and level of physical condition. Women with GDM on no insulin treatment do not need to take extra precautions during exercise. However, due to their condition of hyperglycemia, they must comply with the recommendation issued for type 2 diabetes. The prescription and supervision of exercise should be carried out in a similar way as for uncomplicated pregnancies. Finally, women with GDM on insulin treatment need to follow the same recommendations as for those for pregnant women with type 1 diabetes.

Conclusion

Health professionals must be informed about the correct planning and execution of physical exercise programs so as to safely achieve the maximum effectiveness of exercise-induced health-related benefits in pregnant women.

Keywords

Pregnancy Guidelines Physical exercise Gestational diabetes mellitus 

Abbreviations

ACOG

American College of Obstetricians and Gynecologists

ACSM

American College of Sport Medicine

ADA

American Diabetes Association

APSS

Adult Pre-Exercise Screening System

BMI

Body mass index

bpm

Beats per minute

CSEP

Canadian Society for Exercise Physiology

ESSA

Exercise and Sport Science Australia

FITT

Frequency (F), intensity (I), time (T), and type (T)

GDM

Gestation diabetes mellitus

GLUT4

Glucose transporter type 4

HRR

Heart rate reserve

MET

Metabolic equivalent of task

NELIP

Nutrition and Exercise Lifestyle Intervention Program

PARmed-x

Physical Activity Readiness Medical Examination

SOGC

Society of Obstetricians and Gynecologists of Canada

VO2max

Maximum consumption of oxygen

Notes

Author contributions

D.S. wrote the first draft and edited the manuscript; E.Ta. wrote up the precautions required before initiation of an exercise program; D.G.G. (Endocrinology - Gestational diabetes), E.Ts. (Diet - Gestational diabetes), and S.T. (Clinical Ergophysiology and Exercise) made significant contributions in their areas of expertise and edited the first draft. E.V., H.D., and N.N. edited and revised the manuscript for the intellectual content.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

42000_2018_85_MOESM1_ESM.docx (25 kb)
ESM 1 (DOCX 24 kb)

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Copyright information

© Hellenic Endocrine Society 2018

Authors and Affiliations

  • Dimitra Savvaki
    • 1
    • 2
  • Eleftheria Taousani
    • 2
    • 3
  • Dimitrios G. Goulis
    • 2
  • Efrosini Tsirou
    • 2
  • Evangelia Voziki
    • 2
  • Helen Douda
    • 1
  • Nikolaos Nikolettos
    • 4
  • Savvas P. Tokmakidis
    • 1
  1. 1.School of Physical Education and Sports ScienceDemocritus University of ThraceKomotiniGreece
  2. 2.Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical SchoolAristotle University of ThessalonikiThessalonikiGreece
  3. 3.Department of MidwiferyAlexander Technological Educational Institute of ThessalonikiThessalonikiGreece
  4. 4.Physiology Laboratory, Medical SchoolDemocritus University of ThraceAlexandroupolisGreece

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