Maximizing maternal health: The impact of exercise during pregnancy

In a recent interview, Gabriela Dellapiana, MD, maternal-fetal medicine physician at Cedars-Sinai Medical Center, discussed the benefits of exercise during pregnancy.

Regular physical exercise during pregnancy can reduce the risks of adverse outcomes including gestational diabetes, high blood pressure disorders of pregnancy, and preterm birth. Additionally, psychologic symptoms are improved by exercise, reducing the risks of antenatal depression, postpartum depression, or severe depressive symptoms.

According to Dellapiana, cesarean delivery is also less likely among women with regular exercise during pregnancy. Among patients delivering vaginally, exercise improves the odds of having an intact perineum.

The standard benefits of exercise also apply during pregnancy. These include improved cardiorespiratory fitness, muscular strength, flexibility, endurance, coordination, agility, and body composition.

Dellapiana recommended aerobic exercise during pregnancy because of improved outcomes compared to anaerobic exercise. Pregnant patients have a reduce physiologic pulmonary reserve, which makes anaerobic exercise more difficult because of intense bursts of activity that make up this method of exercise.

In comparison, the constant activity that occurs during aerobic exercise such as walking, stationary cycling, and dancing are preferable during pregnancy. Water aerobics are particularly beneficial as they reduce the force of gravity on the joints, making movement more comfortable. In general, patients should adjust their exercise routine based on their body’s response.

Alongside the benefits of exercise during pregnancy, there are also increased risks from exercise restriction during this time. Activity restriction was considered to be the equivalent of bedrest or sedentary lifestyle during the interview, and is associated with increased blood pressure, cardiovascular deconditioning, and worsened respiratory outcome risks.

Womb absorption risk is also increased by activity restriction, with up to 3% of bone mineral density potentially lost. Other increased risks include blood clot and venous thromboembolism. The risk of gestational diabetes is also increased because of elevated insulin resistance.

Activity restriction may also increase stress in patients who are already feeling isolated during pregnancy. Overall, Dellapiana stated that all patients who are pregnant or planning to be pregnant should speak with their obstetrician or maternal-fetal medicine specialist for support toward exercise during this period.