Development of a new evidence-based SMA position statement on exercise in pregnancy and the post-partum period

Background: Historically, pregnancy was believed to be a time for rest from exercise. However, an increasing body of epidemiological and empirical evidence has recently challenged this view. It is now widely acknowledged that appropriate physical activity and exercise (PAE) undertaken during pregnancy promotes many benefits for both the mother and her unborn child. Despite these benefits, very few pregnant women are sufficiently active to benefit health. In an attempt to help educate pregnant women and healthcare providers, Sports Medicine Australia (SMA) released the first Australian position statement ‘Exercise during Pregnancy’ in 2002. Other peak industry bodies have recently released guidelines for PAE during pregnancy targeting general practitioners, exercise and fitness professionals and pregnant women. However, these guidelines present inconsistent recommendations and none present evidence-based research to guide their recommendations. The aim of this study was to undertake a review of exercise during pregnancy literature, and use the findings to guide the development of a new SMA Position Statement on Exercise in pregnancy and the post-partum period. Methods: A working group of academics (n=3) and health professionals (n=2) was established in 2014. An extensive ‘review of reviews’ approach was used to identify relevant literature published in the last 10 years. Results: The search resulted in 12 systematic and meta-analyses and 9 narrative reviews. These narrative reviews included two peer-reviewed summary papers that included 11 exercise during pregnancy and postpartum guidelines from 9 countries, 6 ‘guidelines’ or ‘fact sheets’ on exercise during pregnancy, 3 scientific reports on Australian and US physical activity guidelines, and a WHO factsheet on obesity and overweight. Each of the above was reviewed by working group members with new evidence informing the development of the 2016 SMA position statement ‘Exercise in pregnancy and the post-partum period’, designed for pregnant women, as well as healthcare providers. Discussion: This new evidence-based position statement will help to guide women and healthcare providers through safe and appropriate PAE during pregnancy, in accordance with best practice recommendations.