Key points

INTRODUCTION

• Physical activity, exercise and sedentary lifestyle are different concepts.
  • Physical activity – Any movement produced by skeletal muscle that results in energy expenditure greater than the resting state
  • Exercise – voluntary, structured, repetitive body movements that require more energy expenditure than physical activity. Your goal is to improve or maintain physical fitness
  • Sedentary lifestyle – Class of behavior characterized by little physical movement and little energy expenditure.
• 40% of women gain more weight than recommended in pregnancy
• On average, after pregnancy there will be a gain of 0.5 to 3 kg of weight retention

COMMON CAUSES OF WEIGHT GAIN IN PREGNANCY AND POSTPARTUM IN MEXICAN WOMEN

• Changes in eating patterns. Increased consumption of sugars and trans fats
• 50% – 60% of pregnant or lactating women decrease physical activity
• Less than 10% are active throughout pregnancy
• During pregnancy there are physical, social, psychological and hormonal changes.
• Lack of knowledge about the benefits of physical activity/exercise
• Lack of social support in childcare
• Living in conditions of poverty confers a risk factor

BARRIERS AND FACILITATORS FOR PHYSICAL ACTIVITY DURING PREGNANCY AND POSTPARTUM IN WOMEN LIVING IN CONDITIONS OF POVERTY IN MEXICO

• Barriers:
  • individual
    • Lack of time
    • Ignorance of the benefits
    • Lack of social support with children
  • sociocultural
    • Lack of counseling by health personnel on physical activity / exercise
    • Prejudice on the part of the community. It is not socially accepted to perform exercise or physical activity in pregnant or lactating women.
    • Lack of a leader-instructor in the community
  • environmental
    • Lack of safe and adequate physical spaces

AUSTRALIAN GUIDELINES – EVIDENCE-BASED PHYSICAL ACTIVITY GUIDELINES FOR PRENGANT WOMEN. MARCH 2021

• All women without contraindications should follow the Australian Physical Activity and Sedentary Behavior Guidelines before, during and after pregnancy – 2021 Guidelines
• Promote physical activity and exercise from before pregnancy, as it facilitates the continuity of these activities
• Doing some physical activity is better than doing nothing
• In the absence of any contraindication, perform moderate-intensity activities for 2.5 to 5 hours per week or vigorous-intensity activities for 1 1/4 to 2.5 hours per week
• Perform muscle-strengthening activities at least 2 days a week
• To define moderate intensity:
  • Use “talk test”: You can have a conversation, but you cannot sing or whistle.
• When to stop physical activity / exercise in pregnancy?
  • In the presence of:
    • Angina
    • Persistent dyspnea that does not subside with rest
    • Severe headache, dizziness that does not go away with rest
    • Painful uterine contractions, vaginal bleeding, or persistent fluid loss
  • Modify activities as the body changes in pregnancy (the center of gravity changes, collisions or falls become more dangerous)
  • Previously inactive women should start at the lower limit of the recommendations (150 mins per week)
  • Previously active women can continue, they should adapt the activities if necessary (due to physical changes typical of pregnancy)
  • Women who exceed the recommendations (>300 mins), can continue training with the supervision of a professional and adapt the training to the pregnancy situation
  • After 28 SDG it is suggested not to exercise in the supine position
  • Avoid activities with risk of:
    • collision, contact
    • Fall risk (activities involving high levels of balance)
    • Pressure changes (skydiving, diving)
    • Heavy lifting
  • Physical activity is associated with:
    • Improvement in cardiorespiratory fitness
    • Less weight gain
    • Protective effect against gestational diabetes and better control of it
    • Performing pelvic exercises during and after pregnancy will reduce the risk of incontinence
    • Decrease in depressive symptoms
    • Not associated with problems in fetal development
    • Protects against unplanned cesarean section
    • Not associated with APGAR score
    • It is not associated with the weight of the baby at birth, however, it decreases the risk of macrosomia

• Additional precautions
  • stay hydrated
  • Do physical activity in a cool environment, avoid heat stress
  • Avoid physical activities at high altitudes (above 2000 m) unless you are acclimatized and trained for the activity before pregnancy
  • Always wear proper footwear, non-restrictive-tight clothing, and pregnancy-safe support top
  • If it's a bit hot, wear loose clothing made of breathable fabric