Evidence-based physical activity guidelines for pregnant women. Report for the Australian Government Department of Health

As part of the suite of national physical activity and sedentary behaviour guidelines for Australians, the Australian Government, in 2018, commissioned a review and synthesis of the evidence to inform the development of practical and safe physical activity guidelines for pregnant Australian women (“the guidelines”). The main purpose of these guidelines is to provide evidence-based best practice recommendations on physical activity/exercise during pregnancy for Australian women and those who provide healthcare during pregnancy. The guidelines may be used to: 1. encourage women to achieve the levels of physical activity/exercise that are recommended for optimal health during pregnancy and in the postpartum period; and 2. provide health professionals with evidence-based guidance on optimal physical activity behaviours during pregnancy and in the postpartum period A five-stage approach, which involved critical ‘umbrella’ reviews of the scientific evidence, and adaptation of recommendations included in recently published guidelines and position statements, was used to develop the Guidelines. We identified 27 ‘critical elements’ of evidence relating to the effects of physical activity/exercise during pregnancy on pregnant women and on fetal development and birth, the effects of physical activity/exercise during the postpartum period, and the effects of sedentary time and occupational physical activity on maternal and infant health outcomes. Narrative reviews of the evidence (2012-2019) relating to each critical element were conducted and the quality of the evidence was rated using the GRADE system. A consensus process, based on the evidence reviews, expert judgements on issues relating to benefits and potential harms, and selected adoption or adaptation of the text used in seven recent guideline documents, was used to draft the proposed Guidelines. The strength of each recommendation in the Guidelines was assessed using National Health and Medical Research Council (NHMRC) guidance. A three stage process was used to review and amend the proposed guidelines. This involved review by international experts, local clinicians and representatives of professional organisations and State or Territory government health departments. The proposed Guidelines and Supporting Information are presented on pages 9-14 of this report.