Semin Reprod Med 2016; 34(02): e28-e37
DOI: 10.1055/s-0036-1583530
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health

Cheryce L. Harrison
1   Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
,
Wendy J. Brown
3   Centre for Research on Exercise Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
,
Melanie Hayman
4   School of Medical and Applied Sciences, Central Queensland University, Queensland, Australia
,
Lisa J. Moran
1   Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
2   The Robinson Research Institute, School of Paediatrics and Reproductive Health, the University of Adelaide, Adelaide, South Australia, Australia
,
Leanne M. Redman
5   Pennington Biomedical Research Center, Baton Rouge, Louisiana
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
11. Mai 2016 (online)

Abstract

The rise in obesity and associated morbidity is currently one of our greatest public health challenges. Women represent a high risk group for weight gain with associated metabolic, cardiovascular, reproductive and psychological health impacts. Regular physical activity is fundamental for health and well-being with protective benefits across the spectrum of women's health. Preconception, pregnancy and the early postpartum period represent opportune windows to engage women in regular physical activity to optimize health and prevent weight gain with added potential to transfer behavior change more broadly to children and families. This review summarizes the current evidence for the role of physical activity for women in relation to preconception (infertility, assisted reproductive therapy, polycystic ovary syndrome, weight gain prevention and psychological well-being) pregnancy (prevention of excess gestational weight gain, gestational diabetes and preeclampsia as well as labor and neonatal outcomes) and postpartum (lactation and breastfeeding, postpartum weight retention and depression) health. Beneficial outcomes validate the importance of regular physical activity, yet key methodological gaps highlight the need for large, high-quality studies to clarify the optimal type, frequency, duration and intensity of physical activity required for beneficial health outcomes during preconception, pregnancy and postpartum.

 
  • References

  • 1 Ng M, Fleming T, Robinson M , et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384 (9945) 766-781
  • 2 Australian Bureau of Statistics. Australian Health Survey: updated results, 2011–2012. ABS cat no 4364055003 Canberra: ABS Available from: http://wwwabsgovau/ausstats/abs@nsf/Lookup/4364055003Chapter12011-2012 [Accessed 16/11/2015]. 2013.
  • 3 Australian Institute of Heath and Welfare (AIHW). Who is Overweight?. Available From: http://www.aihw.gov.au/who-is-overweight/ [Accessed 23/11/2015]. Canberra: AIHW.
  • 4 Chu SY, Callaghan WM, Bish CL, D'Angelo D. Gestational weight gain by body mass index among US women delivering live births, 2004-2005: fueling future obesity. Am J Obstet Gynecol 2009; 200 (3) 271.e1-271.e7
  • 5 Harrison CL, Teede HJ, Lombard CB. How effective is self-weighing in the setting of a lifestyle intervention to reduce gestational weight gain and postpartum weight retention?. Aust N Z J Obstet Gynaecol 2014; 54 (4) 382-385
  • 6 Rasmussen K, Yaktine AL. Eds. Institute of Medicine and National Research Council Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington DC: National Academic Press; 2009
  • 7 Fraser A, Tilling K, Macdonald-Wallis C , et al. Associations of Gestational Weight Gain With Maternal Body Mass Index, Waist Circumference, and Blood Pressure Measured 16 Years After Pregnancy: The Avon Longitudinal Study of Parents and Children. Obstet Gynecol Surv 2011; 66 (10) 599-610
  • 8 Amorim AR, Rössner S, Neovius M, Lourenço PM, Linné Y. Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI?. [ast] Obesity (Silver Spring) 2007; 15 (5) 1278-1286
  • 9 Dye TD, Knox KL, Artal R, Aubry RH, Wojtowycz MA. Physical activity, obesity, and diabetes in pregnancy. Am J Epidemiol 1997; 146 (11) 961-965
  • 10 Willett WC, Manson JE, Stampfer MJ , et al. Weight, weight change, and coronary heart disease in women. Risk within the ‘normal’ weight range. JAMA 1995; 273 (6) 461-465
  • 11 World Health Organisation. Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Geneva: WHO; 2013 [cited 2015 Jan17]; Available from: http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf?ua=1 . Accessed May 3, 2016
  • 12 Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000; 894: i-xii , 1–253
  • 13 Hill JO. Understanding and addressing the epidemic of obesity: an energy balance perspective. Endocr Rev 2006; 27 (7) 750-761
  • 14 Physical Activity Guidelines For Australian Adults. Australian Government Department of Health and Ageing. [updated (Last Updated 2010)]; Available from: http://www.health.gov.au/internet/abhi/publishing.nsf/Content/Physical+activity+guidelines-lp . Accessed May 3, 2016
  • 15 Norton K, Norton L, Sadgrove D. Position statement on physical activity and exercise intensity terminology. J Sci Med Sport 2010; 13 (5) 496-502
  • 16 Garber CE, Blissmer B, Deschenes MR , et al; American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43 (7) 1334-1359
  • 17 UK physical activity guidelines - Fact sheet 4: physical activity guidelines for adults (19–64 years). July 2011. UK Department of Health. . Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/213740/dh_128145.pdf , [Accessed December 22, 2015]
  • 18 Australian Bureau of Statistics . Let's get physical: How do adult Australians measure up? 4156055001 - Perspectives on Sport, Nov 2013 Available from: http://wwwabsgovau/ausstats/abs@nsf/Lookup/4156055001Main+Features3Nov%202013 [Accessed 16/11/2 15]. 2013.
  • 19 Adamson L, Brown W, Byles J , et al. Women's weight: Findings from the Australian Longitudinal Study on Women's Health:Report prepared for the Australian Government Department of Health and Ageing. Australian Government Department of Health and Ageing Available From: http://wwwalswhorgau/images/content/pdf/major_reports/2007_major_report_bpdf [Accessed 16/11/2015]. 2007
  • 20 Brown PR, Brown WJ, Miller YD , et al. Perceived Constraints and Social Support for Active Leisure Among Mothers With Young Children. Leis Sci 2001; 23 (3) 131-144
  • 21 Hillemeier MM, Downs DS, Feinberg ME , et al. Improving women's preconceptional health: findings from a randomized trial of the Strong Healthy Women intervention in the Central Pennsylvania women's health study. Womens Health Issues 2008; 18 (6, Suppl) S87-S96
  • 22 Hammiche F, Laven JSE, van Mil N , et al. Tailored preconceptional dietary and lifestyle counselling in a tertiary outpatient clinic in The Netherlands. Hum Reprod 2011; 26 (9) 2432-2441
  • 23 Temel S, van Voorst SF, Jack BW, Denktaş S, Steegers EA. Evidence-based preconceptional lifestyle interventions. Epidemiol Rev 2014; 36 (1) 19-30
  • 24 Dodd JM, Grivell RM, Crowther CA, Robinson JS. Antenatal interventions for overweight or obese pregnant women: a systematic review of randomised trials. BJOG 2010; 117 (11) 1316-1326
  • 25 Owe KM, Nystad W, Bø K. Correlates of regular exercise during pregnancy: the Norwegian Mother and Child Cohort Study. Scand J Med Sci Sports 2009; 19 (5) 637-645
  • 26 Palomba S, Falbo A, Valli B , et al. Physical activity before IVF and ICSI cycles in infertile obese women: an observational cohort study. Reprod Biomed Online 2014; 29 (1) 72-79
  • 27 Kucuk M, Doymaz F, Urman B. Effect of energy expenditure and physical activity on the outcomes of assisted reproduction treatment. Reprod Biomed Online 2010; 20 (2) 274-279
  • 28 Rich-Edwards JW, Spiegelman D, Garland M , et al. Physical activity, body mass index, and ovulatory disorder infertility. Epidemiology 2002; 13 (2) 184-190
  • 29 Gudmundsdottir SL, Flanders WD, Augestad LB. Physical activity and fertility in women: the North-Trøndelag Health Study. Hum Reprod 2009; 24 (12) 3196-3204
  • 30 Morris SN, Missmer SA, Cramer DW, Powers RD, McShane PM, Hornstein MD. Effects of lifetime exercise on the outcome of in vitro fertilization. Obstet Gynecol 2006; 108 (4) 938-945
  • 31 March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010; 25 (2) 544-551
  • 32 Boyle JA, Cunningham J, O'Dea K, Dunbar T, Norman RJ. Prevalence of polycystic ovary syndrome in a sample of Indigenous women in Darwin, Australia. Med J Aust 2012; 196 (1) 62-66
  • 33 Yildiz BO, Bozdag G, Yapici Z, Esinler I, Yarali H. Prevalence, phenotype and cardiometabolic risk of polycystic ovary syndrome under different diagnostic criteria. Hum Reprod 2012; 27 (10) 3067-3073
  • 34 Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev 1997; 18 (6) 774-800
  • 35 Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med 2010; 8 (1) 41
  • 36 Deeks AA, Gibson-Helm ME, Teede HJ. Anxiety and depression in polycystic ovary syndrome: a comprehensive investigation. Fertil Steril 2010; 93 (7) 2421-2423
  • 37 Moran LJM, Misso ML, Wild RA, Norman RJ. Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 2010; 16 (4) 347-363
  • 38 Meyer C, McGrath BP, Teede HJ. Overweight women with polycystic ovary syndrome have evidence of subclinical cardiovascular disease. J Clin Endocrinol Metab 2005; 90 (10) 5711-5716
  • 39 Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Hum Reprod Update 2009; 15 (4) 477-488
  • 40 Ching HL, Burke V, Stuckey BGA. Quality of life and psychological morbidity in women with polycystic ovary syndrome: body mass index, age and the provision of patient information are significant modifiers. Clin Endocrinol (Oxf) 2007; 66 (3) 373-379
  • 41 Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81 (1) 19-25
  • 42 Zawadaki R, Dockerty MD. Diagnostic criteria for polycystic ovarian syndrome: towards a rational approach. In: Dunaif A, Given JR, Haseltine F, Merriam GR, (Eds)., editor. Current Issues in Endocrinology and Metabolism: Polycystic Ovary Syndrome. Boston: Blackwell Scientific; 1992. . p. 377–84.
  • 43 Corbould A, Kim YB, Youngren JF , et al. Insulin resistance in the skeletal muscle of women with PCOS involves intrinsic and acquired defects in insulin signaling. Am J Physiol Endocrinol Metab 2005; 288 (5) E1047-E1054
  • 44 Diamanti-Kandarakis E, Papavassiliou AG. Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med 2006; 12 (7) 324-332
  • 45 Balen AH, Conway GS, Kaltsas G , et al. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod 1995; 10 (8) 2107-2111
  • 46 Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004; 89 (6) 2745-2749
  • 47 Lim SS, Davies MJ, Norman RJ, Moran LJ. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 2012; 18 (6) 618-637
  • 48 Stepto NK, Cassar S, Joham AE , et al. Women with polycystic ovary syndrome have intrinsic insulin resistance on euglycaemic-hyperinsulaemic clamp. Hum Reprod 2013; 28 (3) 777-784
  • 49 Kiddy DS, Sharp PS, White DM , et al. Differences in clinical and endocrine features between obese and non-obese subjects with polycystic ovary syndrome: an analysis of 263 consecutive cases. Clin Endocrinol (Oxf) 1990; 32 (2) 213-220
  • 50 Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS, Ghazzi MN ; PCOS/Troglitazone Study Group. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2006; 91 (1) 48-53
  • 51 Teede HJ, Misso ML, Deeks AA , et al; Guideline Development Groups. Assessment and management of polycystic ovary syndrome: summary of an evidence-based guideline. Med J Aust 2011; 195 (6) S65-S112
  • 52 Richter EA, Mikines KJ, Galbo H, Kiens B. Effect of exercise on insulin action in human skeletal muscle. J Appl Physiol (1985) 1989; 66 (2) 876-885
  • 53 Knowler WC, Barrett-Connor E, Fowler SE , et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346 (6) 393-403
  • 54 Harrison CL, Stepto NK, Hutchison SK, Teede HJ. The impact of intensified exercise training on insulin resistance and fitness in overweight and obese women with and without polycystic ovary syndrome. Clin Endocrinol (Oxf) 2012; 76 (3) 351-357
  • 55 Harrison CL, Lombard CB, Moran LJ, Teede HJ. Exercise therapy in polycystic ovary syndrome: a systematic review. Hum Reprod Update 2011; 17 (2) 171-183
  • 56 Almenning I, Rieber-Mohn A, Lundgren KM, Shetelig Løvvik T, Garnæs KK, Moholdt T. Effects of High Intensity Interval Training and Strength Training on Metabolic, Cardiovascular and Hormonal Outcomes in Women with Polycystic Ovary Syndrome: A Pilot Study. PLoS ONE 2015; 10 (9) e0138793
  • 57 Vigorito C, Giallauria F, Palomba S , et al. Beneficial effects of a three-month structured exercise training program on cardiopulmonary functional capacity in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2007; 92 (4) 1379-1384
  • 58 Nybacka Å, Carlström K, Ståhle A, Nyrén S, Hellström PM, Hirschberg AL. Randomized comparison of the influence of dietary management and/or physical exercise on ovarian function and metabolic parameters in overweight women with polycystic ovary syndrome. Fertil Steril 2011; 96 (6) 1508-1513
  • 59 Orio F, Giallauria F, Palomba S , et al. Metabolic and cardiopulmonary effects of detraining after a structured exercise training programme in young PCOS women. Clin Endocrinol (Oxf) 2008; 68 (6) 976-981
  • 60 Thomson RL, Buckley JD, Noakes M, Clifton PM, Norman RJ, Brinkworth GD. The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome. J Clin Endocrinol Metab 2008; 93 (9) 3373-3380
  • 61 Palomba S, Giallauria F, Falbo A , et al. Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study. Hum Reprod 2008; 23 (3) 642-650
  • 62 Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK ; American College of Sports Medicine. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2009; 41 (2) 459-471
  • 63 Curioni CC, Lourenço PM. Long-term weight loss after diet and exercise: a systematic review. Int J Obes 2005; 29 (10) 1168-1174
  • 64 Hill JO, Wyatt H, Phelan S, Wing R. The National Weight Control Registry: is it useful in helping deal with our obesity epidemic?. J Nutr Educ Behav 2005; 37 (4) 206-210
  • 65 Wing RR, Phelan S. Long-term weight loss maintenance. Am J Clin Nutr 2005; 82 (1, Suppl) 222S-225S
  • 66 Mekary RA, Feskanich D, Hu FB, Willett WC, Field AE. Physical activity in relation to long-term weight maintenance after intentional weight loss in premenopausal women. Obesity (Silver Spring) 2010; 18 (1) 167-174
  • 67 Conn VS. Anxiety outcomes after physical activity interventions: meta-analysis findings. Nurs Res 2010; 59 (3) 224-231
  • 68 McKercher CM, Schmidt MD, Sanderson KA, Patton GC, Dwyer T, Venn AJ. Physical activity and depression in young adults. Am J Prev Med 2009; 36 (2) 161-164
  • 69 Ströhle A. Physical activity, exercise, depression and anxiety disorders. J Neural Transm (Vienna) 2009; 116 (6) 777-784
  • 70 Vuillemin A, Boini S, Bertrais S , et al. Leisure time physical activity and health-related quality of life. Prev Med 2005; 41 (2) 562-569
  • 71 Bize R, Johnson JA, Plotnikoff RC. Physical activity level and health-related quality of life in the general adult population: a systematic review. Prev Med 2007; 45 (6) 401-415
  • 72 Brown WJ, Mishra G, Lee C, Bauman A. Leisure time physical activity in Australian women: relationship with well being and symptoms. Res Q Exerc Sport 2000; 71 (3) 206-216
  • 73 De Moor MHM, Beem AL, Stubbe JH, Boomsma DI, De Geus EJ. Regular exercise, anxiety, depression and personality: a population-based study. Prev Med 2006; 42 (4) 273-279
  • 74 Gillison FB, Skevington SM, Sato A, Standage M, Evangelidou S. The effects of exercise interventions on quality of life in clinical and healthy populations; a meta-analysis. Soc Sci Med 2009; 68 (9) 1700-1710
  • 75 Thomson RL, Buckley JD, Lim SS , et al. Lifestyle management improves quality of life and depression in overweight and obese women with polycystic ovary syndrome. Fertil Steril 2010; 94 (5) 1812-1816
  • 76 Liao LM, Nesic J, Chadwick PM, Brooke-Wavell K, Prelevic GM. Exercise and body image distress in overweight and obese women with polycystic ovary syndrome: a pilot investigation. Gynecol Endocrinol 2008; 24 (10) 555-561
  • 77 American College of Obstetricians and Gynecologists. ACOG Committee opinion number 650, December 2015. Physical Activity and Exercise During Pregnancy and the Postpartum Period. Available from: http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Physical-Activity-and-Exercise-During-Pregnancy-and-the-Postpartum-Period [Accessed December 1 2015]
  • 78 Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14 (5) 377-381
  • 79 Pivarnik J, Chambliss HO, Clapp JF , et al. Impact of physical activity during pregnancy and postpartum on chronic disease risk. Med Sci Sports Exerc 2006; 38 (5) 989-1006
  • 80 SMA statement the benefits and risks of exercise during pregnancy. Sport Medicine Australia. J Sci Med Sport 2002; 5 (1) 11-19
  • 81 Phelan S, Phipps MG, Abrams B, Darroch F, Schaffner A, Wing RR. Practitioner advice and gestational weight gain. J Womens Health (Larchmt) 2011; 20 (4) 585-591
  • 82 Arslan Ozkan I, Mete S. Pregnancy planning and antenatal health behaviour: findings from one maternity unit in Turkey. Midwifery 2010; 26 (3) 338-347
  • 83 Edvardsson K, Ivarsson A, Eurenius E , et al. Giving offspring a healthy start: parents' experiences of health promotion and lifestyle change during pregnancy and early parenthood. BMC Public Health 2011; 11 (1) 936
  • 84 Stewart ZA, Wallace E, Allan C. Weight gain in pregnancy: a survey of current practices in a teaching hospital. Aust N Z J Obstet Gynaecol 2012; 52 (2) 208-210
  • 85 Duncombe D, Wertheim EH, Skouteris H, Paxton SJ, Kelly L. Factors related to exercise over the course of pregnancy including women's beliefs about the safety of exercise during pregnancy. Midwifery 2009; 25 (4) 430-438
  • 86 Guelinckx I, Devlieger R, Beckers K, Vansant G. Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obes Rev 2008; 9 (2) 140-150
  • 87 Callaway LK, Prins JB, Chang AM, McIntyre HD. The prevalence and impact of overweight and obesity in an Australian obstetric population. Med J Aust 2006; 184 (2) 56-59
  • 88 Abrams B, Selvin S. Maternal weight gain pattern and birth weight. Obstet Gynecol 1995; 86 (2) 163-169
  • 89 Muktabhant B, Lumbiganon P, Ngamjarus C, Dowswell T. Interventions for preventing excessive weight gain during pregnancy. Cochrane Database Syst Rev 2012; 4: CD007145
  • 90 Thangaratinam S, Rogozinska E, Jolly K , et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ 2012; 344: e2088
  • 91 Ferrara A. Increasing prevalence of gestational diabetes mellitus: a public health perspective. Diabetes Care 2007; 30 (Suppl. 02) S141-S146
  • 92 Teh WT, Teede HJ, Paul E, Harrison CL, Wallace EM, Allan C. Risk factors for gestational diabetes mellitus: implications for the application of screening guidelines. Aust N Z J Obstet Gynaecol 2011; 51 (1) 26-30
  • 93 Di Cianni G, Volpe L, Lencioni C , et al. Prevalence and risk factors for gestational diabetes assessed by universal screening. Diabetes Res Clin Pract 2003; 62 (2) 131-137
  • 94 Kühl C. Etiology and pathogenesis of gestational diabetes. Diabetes Care 1998; 21 (Suppl. 02) B19-B26
  • 95 Moses RG, Morris GJ, Petocz P, San Gil F, Garg D. The impact of potential new diagnostic criteria on the prevalence of gestational diabetes mellitus in Australia. Med J Aust 2011; 194 (7) 338-340
  • 96 Metzger BE, Lowe LP, Dyer AR , et al; HAPO Study Cooperative Research Group. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 2008; 358 (19) 1991-2002
  • 97 Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 2002; 25 (10) 1862-1868
  • 98 Ratner RE, Christophi CA, Metzger BE , et al; Diabetes Prevention Program Research Group. Prevention of diabetes in women with a history of gestational diabetes: effects of metformin and lifestyle interventions. J Clin Endocrinol Metab 2008; 93 (12) 4774-4779
  • 99 O'Sullivan JB. Diabetes mellitus after GDM. Diabetes 1991; 40 (Suppl. 02) 131-135
  • 100 Dabelea D. The predisposition to obesity and diabetes in offspring of diabetic mothers. Diabetes Care 2007; 30 (Suppl. 02) S169-S174
  • 101 Russo LM, Nobles C, Ertel KA, Chasan-Taber L, Whitcomb BW. Physical activity interventions in pregnancy and risk of gestational diabetes mellitus: a systematic review and meta-analysis. Obstet Gynecol 2015; 125 (3) 576-582
  • 102 Metzger BE, Buchanan TA, Coustan DR , et al. Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 2007; 30 (Suppl. 02) S251-S260
  • 103 Weissgerber TL, Wolfe LA, Davies GAL, Mottola MF. Exercise in the prevention and treatment of maternal-fetal disease: a review of the literature. Appl Physiol Nutr Metab 2006; 31 (6) 661-674
  • 104 Ceysens G, Rouiller D, Boulvain M. Exercise for diabetic pregnant women. Cochrane Database Syst Rev 2006; 3 (3) CD004225
  • 105 Vest AR, Cho LS. Hypertension in pregnancy. Curr Atheroscler Rep 2014; 16 (3) 395
  • 106 Meher S, Duley L. Exercise or other physical activity for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev 2006; (2) CD005942
  • 107 Aune D, Saugstad OD, Henriksen T, Tonstad S. Physical activity and the risk of preeclampsia: a systematic review and meta-analysis. Epidemiology 2014; 25 (3) 331-343
  • 108 Pivarnik JM, Ayres NA, Mauer MB, Cotton DB, Kirshon B, Dildy GA. Effects of maternal aerobic fitness on cardiorespiratory responses to exercise. Med Sci Sports Exerc 1993; 25 (9) 993-998
  • 109 Price BB, Amini SB, Kappeler K. Exercise in pregnancy: effect on fitness and obstetric outcomes-a randomized trial. Med Sci Sports Exerc 2012; 44 (12) 2263-2269
  • 110 Melzer K, Schutz Y, Boulvain M, Kayser B. Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Med 2010; 40 (6) 493-507
  • 111 Domenjoz I, Kayser B, Boulvain M. Effect of physical activity during pregnancy on mode of delivery. Am J Obstet Gynecol 2014; 211 (4) 401.e1-401.e11
  • 112 Poyatos-León R, García-Hermoso A, Sanabria-Martínez G, Álvarez-Bueno C, Sánchez-López M, Martínez-Vizcaíno V. Effects of exercise during pregnancy on mode of delivery: a meta-analysis. Acta Obstet Gynecol Scand 2015; 94 (10) 1039-1047
  • 113 Tinloy J, Chuang CH, Zhu J, Pauli J, Kraschnewski JL, Kjerulff KH. Exercise during pregnancy and risk of late preterm birth, cesarean delivery, and hospitalizations. Womens Health Issues 2014; 24 (1) e99-e104
  • 114 Jukic AMZ, Evenson KR, Daniels JL, Herring AH, Wilcox AJ, Hartmann KE. A prospective study of the association between vigorous physical activity during pregnancy and length of gestation and birthweight. Matern Child Health J 2012; 16 (5) 1031-1044
  • 115 Klebanoff MA, Shiono PH, Carey JC. The effect of physical activity during pregnancy on preterm delivery and birth weight. Am J Obstet Gynecol 1990; 163 (5 Pt 1) 1450-1456
  • 116 Kramer MS, McDonald SW. Aerobic exercise for women during pregnancy. Cochrane Database Syst Rev 2006; (3) CD000180
  • 117 Wiebe HWBN, Boulé NG, Chari R, Davenport MH. The effect of supervised prenatal exercise on fetal growth: a meta-analysis. Obstet Gynecol 2015; 125 (5) 1185-1194
  • 118 Owe KM, Nystad W, Skjaerven R, Stigum H, Bø K. Exercise during pregnancy and the gestational age distribution: a cohort study. Med Sci Sports Exerc 2012; 44 (6) 1067-1074
  • 119 Davies GA, Wolfe LA, Mottola MF, MacKinnon C ; Society of Obstetricians and gynecologists of Canada, SOGC Clinical Practice Obstetrics Committee. Joint SOGC/CSEP clinical practice guideline: exercise in pregnancy and the postpartum period. Can J Appl Physiol 2003; 28 (3) 330-341
  • 120 Butte NF, King JC. Energy requirements during pregnancy and lactation. Public Health Nutr 2005; 8 
7A, 7a
 1010-1027
  • 121 Walker LO. Managing excessive weight gain during pregnancy and the postpartum period. J Obstet Gynecol Neonatal Nurs 2007; 36 (5) 490-500
  • 122 Amorim Adegboye AR, Linne YM. Diet or exercise, or both, for weight reduction in women after childbirth. Cochrane Database Syst Rev 2013; 7: CD005627
  • 123 Lim S, O'Reilly S, Behrens H, Skinner T, Ellis I, Dunbar JA. Effective strategies for weight loss in post-partum women: a systematic review and meta-analysis. Obes Rev 2015; 16 (11) 972-987
  • 124 Nascimento SL, Pudwell J, Surita FG, Adamo KB, Smith GN. The effect of physical exercise strategies on weight loss in postpartum women: a systematic review and meta-analysis. Int J Obes 2014; 38 (5) 626-635
  • 125 O'Hara MW, Swain AM. Rates and risk of postpartum depression-A meta-analysis. Int Rev Psychiatry 1996; 8 (1) 37-54
  • 126 Blamey RV, Daley AJ, Jolly K. Exercise for postnatal psychological outcomes: a systematic review and meta-analysis. Lancet 2012; 380: S25
  • 127 Armstrong K, Edwards H. The effects of exercise and social support on mothers reporting depressive symptoms: a pilot randomized controlled trial. Int J Ment Health Nurs 2003; 12 (2) 130-138
  • 128 Armstrong K, Edwards H. The effectiveness of a pram-walking exercise programme in reducing depressive symptomatology for postnatal women. Int J Nurs Pract 2004; 10 (4) 177-194
  • 129 Ko Y-L, Yang C-L, Fang C-L, Lee MY, Lin PC. Community-based postpartum exercise program. J Clin Nurs 2013; 22 (15–16) 2122-2131
  • 130 Strøm M, Mortensen EL, Halldorson TI, Osterdal ML, Olsen SF. Leisure-time physical activity in pregnancy and risk of postpartum depression: a prospective study in a large national birth cohort. J Clin Psychiatry 2009; 70 (12) 1707-1714
  • 131 Daley AJ, Foster L, Long G , et al. The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta-analysis. BJOG 2015; 122 (1) 57-62
  • 132 Bahadoran B, Abbasi F, Yousefi A , et al. Evaluating the effect of exercise on the postpartum quality of life. Iran J Nurs Midwifery Res. 2008; 12 (1)
  • 133 Teychenne M, York R. Physical activity, sedentary behavior, and postnatal depressive symptoms: a review. Am J Prev Med 2013; 45 (2) 217-227
  • 134 Songøygard KM, Stafne SN, Evensen KA, Salvesen KÅ, Vik T, Mørkved S. Does exercise during pregnancy prevent postnatal depression? A randomized controlled trial. Acta Obstet Gynecol Scand 2012; 91 (1) 62-67