Table 2.
Absolute and relative contraindications to exercise during pregnancy
| Guidelines | ||||||
|---|---|---|---|---|---|---|
| Canada | Japan | Norway* | Spain | United Kingdom* | United States (ACOG) | |
| Absolute Contraindications: | ||||||
| Abnormal amniotic fluid | X | |||||
| Bleeding, persistent | 2nd–3rd trimester | X | months 4–9 | X | 2nd–3rd trimester | 2nd–3rd trimester |
| CVD | serious | X | X | active CVD, cardiac failure, rheumatic disease | X | hemodynamically significant |
| Cerclage, incompetent cervix | X | X | X | X | cervical weakness | X |
| Diabetes mellitus | uncontrolled type 1 | |||||
| Fetal abnormality | X | |||||
| Fetal growth restriction | X | X | ||||
| History of fetal growth restriction | X | X | reduce in 2nd–3rd trimester | |||
| History of miscarriage, >=3 | X | |||||
| History of preterm birth | X | |||||
| History of preterm labor | X | reduce in 2nd–3rd trimester | ||||
| Hypertonia, poorly controlled | X | |||||
| Infectious disease, acute | X | |||||
| Lung disease, restrictive | X | X | X | X | ||
| Multiple gestation | triplets and higher | X | X | X | X | X |
| Placenta previa | symptomatic bleeding | X | X | after 26 weeks | after 26 weeks | |
| Preeclampsia, pregnancy induced hypertension | X | X | X | X | X | X |
| Premature contractions or labor | X | X | X | X | X | X |
| Premature rupture of membranes | X | X | X | X | X | X |
| Respiratory disease, serious | X | pulmonary embolism | ||||
| Rh+/Rh− immunologic disorder | X | |||||
| Systemic disorder, uncontrolled | X | |||||
| Thyroid disease, uncontrolled | X | |||||
| Thrombophlebitis | X | |||||
| Relative Contraindications: | ||||||
| Anemia | hemoglobin <100 g/L | or other bleeding disorder | X | severe | hemoglobin <100 g/L | severe |
| Arrythmia | X | non-assessed | unevaluated | unevaluated | ||
| Bronchitis, chronic | X | X | X | X | ||
| Cardiovascular disorder, mild to moderate | X | X | X | |||
| Diabetes mellitus | X | poorly controlled | poorly controlled | poorly controlled type 1 | ||
| Eating disorder | X | anorexia | X | X | ||
| History of extremely sedentary lifestyle | X | X | X | |||
| History of fetal growth restriction | X | |||||
| History of preterm birth | X | X | ||||
| History of preterm labor | X | X | ||||
| History of spontaneous abortion | X | |||||
| Hypertension | X | X | poorly controlled | poorly controlled | ||
| Intrauterine growth restriction | X | X | X | |||
| Malnutrition | X | X | X | |||
| Multiple gestation, twins | after 28 weeks | |||||
| Obesity, morbid (BMI >40 kg/m2) | X | X | X | X | X | |
| Orthopedic limitation | X | X | X | |||
| Respiratory disorder, mild to moderate | X | X | ||||
| Seizures, poorly controlled | epilepsy | X | X | |||
| Smoker, current | >20 cigarettes/day | >20 cigarettes/day | heavy smoker | |||
| Thyroid disease | X | X | X | poorly controlled | poorly controlled hyperthroidism | |
| Underweight, extreme (BMI<12 kg/m2) | extreme thinness | extreme thinness | X | |||
BMI=body mass index; CVD=cardiovascular diseaes
*
Distinction between relative and absolute contraindications not made.
Note: The Australia, Denmark, France, and USDHHS guidelines did not include contraindications, as the guidelines were all geared towards healthy women with normal pregnancies.