| For pregnant women, exercise offers numerous benefits with little
risk. The American College of Obstetricians and Gynecologists (ACOG)
endorses aerobic exercise for all pregnant women without medical or
obstetric complications. Nonetheless, only a small percentage of pregnant
women meet exercise guidelines. We investigated the extent to which
obstetricians (Obs) in private or small group practice in the USA
actively recommend exercise to their pregnant patients. Surveys were
sent to 300 Obs in 33 American cities, of which 83 were returned.
52% of respondents reported discussing exercise with 81-100% of their
patients. Using a 7- point Likert scale (1 = never, 7 = always), Obs
reported recommending aerobic exercise more often than resistance
exercise (5.6 ± 1.5 versus 3.8 ± 1.6, p < 0.001). Obs do not routinely
advise sedentary women to initiate exercise during pregnancy (mean
4.4 ± 1.8). Of the 67% of Obs who specify a target exercise duration,
95% recommend > 16 min, consistent with ACOG guidelines.
However, 62% of Obs reported that they regularly specify a maximum
heart rate, even though ACOG guidelines do not. Half of respondents
indicated that they advise a reduction in exercise load during the
third trimester, even for uncomplicated pregnancies. Respondents'
opinions were mixed regarding the extent to which exercise reduces
gestational diabetes or preeclampsia risk and they believe more research
on exercise during pregnancy is needed. Half of Obs do not routinely
discuss exercise. The majority is hesitant to advise sedentary gravidae
to start exercise and is conservative with respect to exercise intensity.
Action may be needed to convince more Obs to routinely recommend exercise
to all healthy patients.
KEY
WORDS: Physical activity, prenatal activity, pregnant women,
guidelines for exercise.
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