Physical Activity and Pregnancy: Difference between revisions

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== Introduction  ==
== Introduction  ==


Physical activity is defined as any bodily movement produced by skeleta muscles that result in energy expediture. Exercise is a subset of physical activity that is planned,structured, repeated and has a final or an intermediate objective to the improvement or maintenance of physical fitness<ref>Caspersen, C. J., Powell, K. E., &amp;amp; Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports (Washington, D.C. : 1974), 100(2), 126–31. https://doi.org/10.2307/20056429)</ref>
Physical activity is defined as any bodily movement produced by skeleta muscles that result in energy expediture. Exercise is a subset of physical activity that is planned,structured, repeated and has a final or an intermediate objective to the improvement or maintenance of physical fitness<ref>Caspersen, C. J., Powell, K. E., &amp;amp;amp; Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports (Washington, D.C. : 1974), 100(2), 126–31. https://doi.org/10.2307/20056429)</ref>  


-Pregnancy could be a great time for life style modifications. Moderate intensity exercises are proven to be beneficial for both mother and fetus in low risk pregnancy with the necessary modifications<ref>VICTOR KATCH  Katch, Victor ( 2017, February, 5) Pregnancy And Physical Activity Retrieved from http://michigantoday.umich.edu/pregnancy-and-physical-activity/.</ref>.
-Pregnancy could be a great time for life style modifications. Moderate intensity exercises are proven to be beneficial for both mother and fetus in low risk pregnancy with the necessary modifications<ref>VICTOR KATCH  Katch, Victor ( 2017, February, 5) Pregnancy And Physical Activity Retrieved from http://michigantoday.umich.edu/pregnancy-and-physical-activity/.</ref>.  


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==== Prevalence: ====
==== Prevalence: ====


-In the United states, one study reported that only 15.8 % of women are engaged in exercises during pregnancy at the recommended level<ref>Evenson KR, Savitz DA, Huston SL. Lesure-time physical activity among pregnant women in the US. Paediatr Perinat Epidemiol 2004; 18:400–407.</ref>.
-In the United states, one study reported that only 15.8&nbsp;% of women are engaged in exercises during pregnancy at the recommended level<ref>Evenson KR, Savitz DA, Huston SL. Lesure-time physical activity among pregnant women in the US. Paediatr Perinat Epidemiol 2004; 18:400–407.</ref>.  


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==== Benefits of physical activities for the mother:  ====
==== Benefits of physical activities for the mother:  ====


''Exercise and weight managment:''<br>&nbsp; &nbsp;-Weiht gain during pregnancy , known as Gestational weight gain (GWG). The Institute of Medicine &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; recommends GWG for underweight, normal weight, overweight, and obese women of 12.5-18, 11.5-16, &nbsp; &nbsp; 7-11.5 and 5-9 kgs respectively<ref>Barakat, R., Perales, M., Garatachea, N., Ruiz, J. R., &amp;amp; Lucia, A. (n.d.). Exercise during pregnancy . A narrative review asking : what do we know ?, 1377–1381. https://doi.org/10.1136/bjsports-2015-094756</ref>. High percentage of women exceeds the recommended weight.<ref>Davenport MH, Steinback CD, Mottola MF. Impact of pregnancy and obesity on cardiorespiratory responses during weight-bearing exercise. Respir Physiol Neurobiol 2009;167:341–7.</ref>
''Exercise and weight managment:''<br>&nbsp; &nbsp;-Weiht gain during pregnancy , known as Gestational weight gain (GWG). The Institute of Medicine &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; recommends GWG for underweight, normal weight, overweight, and obese women of 12.5-18, 11.5-16, &nbsp; &nbsp; 7-11.5 and 5-9 kgs respectively<ref>Barakat, R., Perales, M., Garatachea, N., Ruiz, J. R., &amp;amp;amp; Lucia, A. (n.d.). Exercise during pregnancy . A narrative review asking : what do we know ?, 1377–1381. https://doi.org/10.1136/bjsports-2015-094756</ref>. High percentage of women exceeds the recommended weight.<ref>Davenport MH, Steinback CD, Mottola MF. Impact of pregnancy and obesity on cardiorespiratory responses during weight-bearing exercise. Respir Physiol Neurobiol 2009;167:341–7.</ref>  


&nbsp; &nbsp; -Excessive GWG is associated with high risk of gestational diabetes mellitus (GDM) , hypertension<ref>Gaillard R, Durmus B, Hofman A, et al. Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy. Obesity 2013;21:1046–55.</ref>, &nbsp; &nbsp; cesarean delivery and postpartum weight retention<ref>Hedderson, M., EP, G., &amp;amp; Ferrara, A. (2011). Gestational Weight Gain and Risk of Gestational Diabetes Mellitus. Obstet Gynecol, 115(3), 597–604. https://doi.org/10.1097/AOG.0b013e3181cfce4f.Gestational)</ref>.  
&nbsp; &nbsp; -Excessive GWG is associated with high risk of gestational diabetes mellitus (GDM) , hypertension<ref>Gaillard R, Durmus B, Hofman A, et al. Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy. Obesity 2013;21:1046–55.</ref>, &nbsp; &nbsp; cesarean delivery and postpartum weight retention<ref>Hedderson, M., EP, G., &amp;amp;amp; Ferrara, A. (2011). Gestational Weight Gain and Risk of Gestational Diabetes Mellitus. Obstet Gynecol, 115(3), 597–604. https://doi.org/10.1097/AOG.0b013e3181cfce4f.Gestational)</ref>.  


&nbsp; &nbsp; -Regular physical activity during pregnancy can reduce GWG by an average of 6.8 pounds compared &nbsp; &nbsp; &nbsp; &nbsp;to women who do not exercise regularly<ref>Evenson KR, Savitz DA, Huston SL. Lesure-time physical activity among pregnant women in the US. Paediatr Perinat Epidemiol 2004; 18:400–407.</ref>.  
&nbsp; &nbsp; -Regular physical activity during pregnancy can reduce GWG by an average of 6.8 pounds compared &nbsp; &nbsp; &nbsp; &nbsp;to women who do not exercise regularly<ref>Evenson KR, Savitz DA, Huston SL. Lesure-time physical activity among pregnant women in the US. Paediatr Perinat Epidemiol 2004; 18:400–407.</ref>.  


 
<br>


''* Exercise and Cardiac and respiratory fitness:''<br>&nbsp; &nbsp; -Pregnancy is accompained by many cardiac and respiratory changes that begin during the fifth week &nbsp; &nbsp; &nbsp; &nbsp;of gestation and last until about a year after delivery<ref>Clapp JF III, Capeless E. Cardiovascular function before, during, and after the first and subsequent pregnancies. Am J Cardiol 1997;80:1469–73.</ref>. Cardiac output and blood volume increase up &nbsp; &nbsp; &nbsp;to 40%<ref>Geva T, Mauer MB, Striker L, et al. Effects of physiologic load of pregnancy on left ventricular contractility and remodeling. Am Heart J 1997;133:53–9.</ref>&nbsp;<ref>Gilson GJ, Samaan S, Crawford MH, et al. Changes in hemodynamics, ventricular remodeling, and ventricular contractility during normal pregnancy: a longitudinal study. Obstet Gynecol 1997;89:957–62.</ref>. Tidal volume and oxygen consumption (VO2) also increase to supply the oxygen &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;requirments of the fetus.<br>&nbsp; &nbsp; -Aerobic exercise such as swimming, static cycling and general floor exercise programs, at least two &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;to three times per week is recommended to maintain cardiovascular fitness<ref>*Exercise and Psychological well-being: fckLR-Pregnancy can also be a time of major emotional change. Many women suffer alterations in mood and even prenatal depression. Recent studies have estimated the prevalence of depression during pregnancy to be between 10% and 30% .fckLRfckLR-The women who keep fit during pregnancy are more relaxed and cope better with the emotional and physiological strains of pregnancy, this is attributed to a number of positive effects from exercise such as weight management, better body image and self-esteem, improved sleep, and increased energy level. fckLR-Exercises may be also effective in treating antenatal depression .</ref>, reduces ventilatory &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;demands, enhances the breathing pattern and eventually inhibits exertional breathing problems occur &nbsp; &nbsp; &nbsp; &nbsp;in pregnancy.  
''* Exercise and Cardiac and respiratory fitness:''<br>&nbsp; &nbsp; -Pregnancy is accompained by many cardiac and respiratory changes that begin during the fifth week &nbsp; &nbsp; &nbsp; &nbsp;of gestation and last until about a year after delivery<ref>Clapp JF III, Capeless E. Cardiovascular function before, during, and after the first and subsequent pregnancies. Am J Cardiol 1997;80:1469–73.</ref>. Cardiac output and blood volume increase up &nbsp; &nbsp; &nbsp;to 40%<ref>Geva T, Mauer MB, Striker L, et al. Effects of physiologic load of pregnancy on left ventricular contractility and remodeling. Am Heart J 1997;133:53–9.</ref>&nbsp;<ref>Gilson GJ, Samaan S, Crawford MH, et al. Changes in hemodynamics, ventricular remodeling, and ventricular contractility during normal pregnancy: a longitudinal study. Obstet Gynecol 1997;89:957–62.</ref>. Tidal volume and oxygen consumption (VO2) also increase to supply the oxygen &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;requirments of the fetus.<br>&nbsp; &nbsp; -Aerobic exercise such as swimming, static cycling and general floor exercise programs, at least two &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;to three times per week is recommended to maintain cardiovascular fitness<ref>*Exercise and Psychological well-being: fckLR-Pregnancy can also be a time of major emotional change. Many women suffer alterations in mood and even prenatal depression. Recent studies have estimated the prevalence of depression during pregnancy to be between 10% and 30% .fckLRfckLR-The women who keep fit during pregnancy are more relaxed and cope better with the emotional and physiological strains of pregnancy, this is attributed to a number of positive effects from exercise such as weight management, better body image and self-esteem, improved sleep, and increased energy level. fckLR-Exercises may be also effective in treating antenatal depression .</ref>, reduces ventilatory &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;demands, enhances the breathing pattern and eventually inhibits exertional breathing problems occur &nbsp; &nbsp; &nbsp; &nbsp;in pregnancy.  
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&nbsp; &nbsp; -pregnany can also be a time of major emotional changes. M any women suffer alterations in mood &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; and enev prenatal depression. Recent studies have estimated the prevalence of depression during &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; pregnancy to be between 10% and 30%<ref>Teixeira C vc    /, Figueiredo B, Conde A, et al. Anxiety and depression during pregnancy in women and men. J Affect Disord 2009;119:142–8.</ref>.  
&nbsp; &nbsp; -pregnany can also be a time of major emotional changes. M any women suffer alterations in mood &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; and enev prenatal depression. Recent studies have estimated the prevalence of depression during &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; pregnancy to be between 10% and 30%<ref>Teixeira C vc    /, Figueiredo B, Conde A, et al. Anxiety and depression during pregnancy in women and men. J Affect Disord 2009;119:142–8.</ref>.  


&nbsp; &nbsp;-The women who keep fit during pregnancy are more relaxed and cope better with the emotional and &nbsp; &nbsp; &nbsp; &nbsp; physiological strains of pregnancy, this is attributed to a number of positive effects from exercise such &nbsp; &nbsp; &nbsp; as &nbsp;weight management, better body image and self-esteem, improved sleep, and increased energy &nbsp; &nbsp; &nbsp; &nbsp; level<ref>Qassim, S., Assistant, M., Dean, A., Education, P., &amp;amp; View, G. (2016). Some Aspects of the Muscular Strength for the Volley Ball Players and Javelin Players in Athletics, (June).</ref>  
&nbsp; &nbsp;-The women who keep fit during pregnancy are more relaxed and cope better with the emotional and &nbsp; &nbsp; &nbsp; &nbsp; physiological strains of pregnancy, this is attributed to a number of positive effects from exercise such &nbsp; &nbsp; &nbsp; as &nbsp;weight management, better body image and self-esteem, improved sleep, and increased energy &nbsp; &nbsp; &nbsp; &nbsp; level<ref>Qassim, S., Assistant, M., Dean, A., Education, P., &amp;amp;amp; View, G. (2016). Some Aspects of the Muscular Strength for the Volley Ball Players and Javelin Players in Athletics, (June).</ref>  


&nbsp; &nbsp; -Exercises may also be effective in treating antenatal depression<ref>Daley, A.J., et al. 2015. “The effectiveness of exercise for the prevention and treatment of antenatal depression: Systematic review with meta-analysis.” British Journal of Obstetrics and Gynecology; 122(1):57.</ref>.  
&nbsp; &nbsp; -Exercises may also be effective in treating antenatal depression<ref>Daley, A.J., et al. 2015. “The effectiveness of exercise for the prevention and treatment of antenatal depression: Systematic review with meta-analysis.” British Journal of Obstetrics and Gynecology; 122(1):57.</ref>.  


''*Back pain:''
''*Back pain:'' &nbsp; &nbsp;-Pregnaant women typically develop lumbar lordosis, which contribute to the very high prevalence &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;(50%) of low back pain in pregnanat women<ref>Artal, R. (n.d.). Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period, 6–13.</ref>.  
&nbsp; &nbsp;-Pregnaant women typically develop lumbar lordosis, which contribute to the very high prevalence &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;(50%) of low back pain in pregnanat women<ref>Artal, R. (n.d.). Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period, 6–13.</ref>.  


&nbsp; &nbsp;-Exercises in general in addition to Lumbar sstabilization exercises are helpful to reduce the intensity of &nbsp; &nbsp; &nbsp;back pain<ref>Garshasbi, A. and Faghih Zadeh, S. (2005), The effect of exercise on the intensity of low back pain in pregnant women. International Journal of Gynecology &amp;amp; Obstetrics, 88: 271–275. doi:10.1016/j.ijgo.2004.12.001)</ref><ref>Elden, H. "Effects Of Acupuncture And Stabilising Exercises As Adjunct To Standard Treatment In Pregnant Women With Pelvic Girdle Pain: Randomised Single Blind Controlled Trial". BMJ 330.7494 (2005): 761-0. Web.</ref>.  
&nbsp; &nbsp;-Exercises in general in addition to Lumbar sstabilization exercises are helpful to reduce the intensity of &nbsp; &nbsp; &nbsp;back pain<ref>Garshasbi, A. and Faghih Zadeh, S. (2005), The effect of exercise on the intensity of low back pain in pregnant women. International Journal of Gynecology &amp;amp;amp; Obstetrics, 88: 271–275. doi:10.1016/j.ijgo.2004.12.001)</ref><ref>Elden, H. "Effects Of Acupuncture And Stabilising Exercises As Adjunct To Standard Treatment In Pregnant Women With Pelvic Girdle Pain: Randomised Single Blind Controlled Trial". BMJ 330.7494 (2005): 761-0. Web.</ref>.  


<br>''*Labor outcomes:''  
<br>''*Labor outcomes:''  
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&nbsp; &nbsp;-Pregnant women who maintain a regular exercise routine, experience less painful , and short duration &nbsp; &nbsp; &nbsp; delivery<ref>Clapp JF., 3rd . Am J Obstet Gynecol. 6 Pt 1. Vol. 163. 1799-805: 1990. The course of labor after endurance exercise during pregnancy. [PubMed]</ref>. This is attributed to the exercise effect on inducing metabolic and hormonal changes that &nbsp; &nbsp; &nbsp; may impact uterine contractility and endurance<ref>Salvesen KA, Stafne SN, Eggebo TM, et al. Does regular exercise in pregnancyfckLRinfluence duration of labor? A secondary analysis of a randomized controlled trial.fckLRActa Obstet Gynecol Scand 2014;93:73–9.</ref>.  
&nbsp; &nbsp;-Pregnant women who maintain a regular exercise routine, experience less painful , and short duration &nbsp; &nbsp; &nbsp; delivery<ref>Clapp JF., 3rd . Am J Obstet Gynecol. 6 Pt 1. Vol. 163. 1799-805: 1990. The course of labor after endurance exercise during pregnancy. [PubMed]</ref>. This is attributed to the exercise effect on inducing metabolic and hormonal changes that &nbsp; &nbsp; &nbsp; may impact uterine contractility and endurance<ref>Salvesen KA, Stafne SN, Eggebo TM, et al. Does regular exercise in pregnancyfckLRinfluence duration of labor? A secondary analysis of a randomized controlled trial.fckLRActa Obstet Gynecol Scand 2014;93:73–9.</ref>.  


&nbsp; -Exercises during pregnancy are also associated with reduced need for Ceasarean section<ref>Tinloy J, Chuang CH, Zhu J, et al. Exercise during pregnancy and risk of latefckLRpreterm birth, cesarean delivery, and hospitalizations. Womens Health IssuesfckLR2014;24:e99–e104.</ref>.<br><br>*''Urinary Incontinence:''
&nbsp; -Exercises during pregnancy are also associated with reduced need for Ceasarean section<ref>Tinloy J, Chuang CH, Zhu J, et al. Exercise during pregnancy and risk of latefckLRpreterm birth, cesarean delivery, and hospitalizations. Womens Health IssuesfckLR2014;24:e99–e104.</ref>.<br><br>*''Urinary Incontinence:'' &nbsp; &nbsp;-Pelvic floor strngthening exercises during pregnancy are helpful in prevention and reducing the &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;symptoms of urinary incontinence<ref>Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med 2014;48:299–310. 85 Bø K, Haakstad LA. Is pelvic floor muscle training</ref>.  
&nbsp; &nbsp;-Pelvic floor strngthening exercises during pregnancy are helpful in prevention and reducing the &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;symptoms of urinary incontinence<ref>Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med 2014;48:299–310. 85 Bø K, Haakstad LA. Is pelvic floor muscle training</ref>.  


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== References  ==
== References  ==

Revision as of 09:10, 3 June 2017

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Introduction[edit | edit source]

Physical activity is defined as any bodily movement produced by skeleta muscles that result in energy expediture. Exercise is a subset of physical activity that is planned,structured, repeated and has a final or an intermediate objective to the improvement or maintenance of physical fitness[1]

-Pregnancy could be a great time for life style modifications. Moderate intensity exercises are proven to be beneficial for both mother and fetus in low risk pregnancy with the necessary modifications[2].


Prevalence:[edit | edit source]

-In the United states, one study reported that only 15.8 % of women are engaged in exercises during pregnancy at the recommended level[3].



Benefits of physical activities for the mother:[edit | edit source]

Exercise and weight managment:
   -Weiht gain during pregnancy , known as Gestational weight gain (GWG). The Institute of Medicine             recommends GWG for underweight, normal weight, overweight, and obese women of 12.5-18, 11.5-16,     7-11.5 and 5-9 kgs respectively[4]. High percentage of women exceeds the recommended weight.[5]

    -Excessive GWG is associated with high risk of gestational diabetes mellitus (GDM) , hypertension[6],     cesarean delivery and postpartum weight retention[7].

    -Regular physical activity during pregnancy can reduce GWG by an average of 6.8 pounds compared        to women who do not exercise regularly[8].


* Exercise and Cardiac and respiratory fitness:
    -Pregnancy is accompained by many cardiac and respiratory changes that begin during the fifth week        of gestation and last until about a year after delivery[9]. Cardiac output and blood volume increase up      to 40%[10] [11]. Tidal volume and oxygen consumption (VO2) also increase to supply the oxygen                requirments of the fetus.
    -Aerobic exercise such as swimming, static cycling and general floor exercise programs, at least two          to three times per week is recommended to maintain cardiovascular fitness[12], reduces ventilatory            demands, enhances the breathing pattern and eventually inhibits exertional breathing problems occur        in pregnancy.

*Exercise and Psychological well-being:

    -pregnany can also be a time of major emotional changes. M any women suffer alterations in mood           and enev prenatal depression. Recent studies have estimated the prevalence of depression during           pregnancy to be between 10% and 30%[13].

   -The women who keep fit during pregnancy are more relaxed and cope better with the emotional and         physiological strains of pregnancy, this is attributed to a number of positive effects from exercise such       as  weight management, better body image and self-esteem, improved sleep, and increased energy         level[14]

    -Exercises may also be effective in treating antenatal depression[15].

*Back pain:    -Pregnaant women typically develop lumbar lordosis, which contribute to the very high prevalence              (50%) of low back pain in pregnanat women[16].

   -Exercises in general in addition to Lumbar sstabilization exercises are helpful to reduce the intensity of      back pain[17][18].


*Labor outcomes:

   -Pregnant women who maintain a regular exercise routine, experience less painful , and short duration       delivery[19]. This is attributed to the exercise effect on inducing metabolic and hormonal changes that       may impact uterine contractility and endurance[20].

  -Exercises during pregnancy are also associated with reduced need for Ceasarean section[21].

*Urinary Incontinence:    -Pelvic floor strngthening exercises during pregnancy are helpful in prevention and reducing the                  symptoms of urinary incontinence[22].







References[edit | edit source]

References will automatically be added here, see adding references tutorial.

  1. ↑ Caspersen, C. J., Powell, K. E., &amp;amp; Christenson, G. M. (1985). Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Reports (Washington, D.C. : 1974), 100(2), 126–31. https://doi.org/10.2307/20056429)
  2. ↑ VICTOR KATCH Katch, Victor ( 2017, February, 5) Pregnancy And Physical Activity Retrieved from http://michigantoday.umich.edu/pregnancy-and-physical-activity/.
  3. ↑ Evenson KR, Savitz DA, Huston SL. Lesure-time physical activity among pregnant women in the US. Paediatr Perinat Epidemiol 2004; 18:400–407.
  4. ↑ Barakat, R., Perales, M., Garatachea, N., Ruiz, J. R., &amp;amp; Lucia, A. (n.d.). Exercise during pregnancy . A narrative review asking : what do we know ?, 1377–1381. https://doi.org/10.1136/bjsports-2015-094756
  5. ↑ Davenport MH, Steinback CD, Mottola MF. Impact of pregnancy and obesity on cardiorespiratory responses during weight-bearing exercise. Respir Physiol Neurobiol 2009;167:341–7.
  6. ↑ Gaillard R, Durmus B, Hofman A, et al. Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy. Obesity 2013;21:1046–55.
  7. ↑ Hedderson, M., EP, G., &amp;amp; Ferrara, A. (2011). Gestational Weight Gain and Risk of Gestational Diabetes Mellitus. Obstet Gynecol, 115(3), 597–604. https://doi.org/10.1097/AOG.0b013e3181cfce4f.Gestational)
  8. ↑ Evenson KR, Savitz DA, Huston SL. Lesure-time physical activity among pregnant women in the US. Paediatr Perinat Epidemiol 2004; 18:400–407.
  9. ↑ Clapp JF III, Capeless E. Cardiovascular function before, during, and after the first and subsequent pregnancies. Am J Cardiol 1997;80:1469–73.
  10. ↑ Geva T, Mauer MB, Striker L, et al. Effects of physiologic load of pregnancy on left ventricular contractility and remodeling. Am Heart J 1997;133:53–9.
  11. ↑ Gilson GJ, Samaan S, Crawford MH, et al. Changes in hemodynamics, ventricular remodeling, and ventricular contractility during normal pregnancy: a longitudinal study. Obstet Gynecol 1997;89:957–62.
  12. ↑ *Exercise and Psychological well-being: fckLR-Pregnancy can also be a time of major emotional change. Many women suffer alterations in mood and even prenatal depression. Recent studies have estimated the prevalence of depression during pregnancy to be between 10% and 30% .fckLRfckLR-The women who keep fit during pregnancy are more relaxed and cope better with the emotional and physiological strains of pregnancy, this is attributed to a number of positive effects from exercise such as weight management, better body image and self-esteem, improved sleep, and increased energy level. fckLR-Exercises may be also effective in treating antenatal depression .
  13. ↑ Teixeira C vc /, Figueiredo B, Conde A, et al. Anxiety and depression during pregnancy in women and men. J Affect Disord 2009;119:142–8.
  14. ↑ Qassim, S., Assistant, M., Dean, A., Education, P., &amp;amp; View, G. (2016). Some Aspects of the Muscular Strength for the Volley Ball Players and Javelin Players in Athletics, (June).
  15. ↑ Daley, A.J., et al. 2015. “The effectiveness of exercise for the prevention and treatment of antenatal depression: Systematic review with meta-analysis.” British Journal of Obstetrics and Gynecology; 122(1):57.
  16. ↑ Artal, R. (n.d.). Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period, 6–13.
  17. ↑ Garshasbi, A. and Faghih Zadeh, S. (2005), The effect of exercise on the intensity of low back pain in pregnant women. International Journal of Gynecology &amp;amp; Obstetrics, 88: 271–275. doi:10.1016/j.ijgo.2004.12.001)
  18. ↑ Elden, H. "Effects Of Acupuncture And Stabilising Exercises As Adjunct To Standard Treatment In Pregnant Women With Pelvic Girdle Pain: Randomised Single Blind Controlled Trial". BMJ 330.7494 (2005): 761-0. Web.
  19. ↑ Clapp JF., 3rd . Am J Obstet Gynecol. 6 Pt 1. Vol. 163. 1799-805: 1990. The course of labor after endurance exercise during pregnancy. [PubMed]
  20. ↑ Salvesen KA, Stafne SN, Eggebo TM, et al. Does regular exercise in pregnancyfckLRinfluence duration of labor? A secondary analysis of a randomized controlled trial.fckLRActa Obstet Gynecol Scand 2014;93:73–9.
  21. ↑ Tinloy J, Chuang CH, Zhu J, et al. Exercise during pregnancy and risk of latefckLRpreterm birth, cesarean delivery, and hospitalizations. Womens Health IssuesfckLR2014;24:e99–e104.
  22. ↑ Mørkved S, Bø K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med 2014;48:299–310. 85 Bø K, Haakstad LA. Is pelvic floor muscle training
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