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Seminar – Physical activity in pregnancy and postpartum

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

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