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Research ArticlePractice

Risk assessment for physical activity and exercise clearance

In pregnant women without contraindications

Shannon S.D. Bredin, Heather J.A. Foulds, Jamie F. Burr and Sarah A. Charlesworth
Canadian Family Physician May 2013; 59 (5) 515-517;
Shannon S.D. Bredin
Assistant Professor in the School of Kinesiology at the University of British Columbia in Vancouver, Director of the Cognitive and Functional Learning Laboratory and the Systematic Reviews Research Laboratory, and Co-Director of the Physical Activity and Chronic Disease Prevention Unit. She is also Co-Director of the Physical Activity Support Line and a certified exercise physiologist.
PhD
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  • For correspondence: shannon.bredin@ubc.ca
Heather J.A. Foulds
MSc
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Jamie F. Burr
PhD
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Sarah A. Charlesworth
PhD
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    Figure 1

    Clinical decision tree for assessing the risk of adverse events during physical activity in pregnant women: This decision tree can be used to categorize a pregnant woman as high or low risk, thereby informing requirements for the prescription of physical activity and the monitoring of exercise programs.

    *Despite being at low risk, pregnant women who were not previously active might wish to consult qualified exercise professionals for advice on preferred activities.

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    Table 1

    Evidence-based recommendations for consideration in physical activity screening in pregnant women without contraindications

    RECOMMENDATIONLEVEL*GRADE†
    There is no evidence that previously inactive or active women (without contraindications) are at risk of adverse fetal events if they participate in routine physical activity throughout pregnancy. Pregnant women without contraindications should be encouraged to partake in a variety of moderate-intensity physical activities (eg, walking, stationary cycling, swimming)IIIB
    Pregnant women without contraindications (who were previously active or inactive before pregnancy) are at low risk of adverse maternal events if they participate in routine moderate-intensity physical activities (eg, walking, stationary cycling, swimming). Pregnant women should be encouraged to partake in routine physical activityIIB
    Healthy women with uncomplicated pregnancies can be stratified as low risk irrespective of activity level before pregnancy. Further systematic evaluation is required to determine the risk of adverse exercise-related events in pregnant women presenting with pre-existing medical conditions or contraindications to exerciseIIIA
    • ↵* Level I evidence includes randomized controlled trials; level II evidence includes randomized controlled trials with important limitations or observational trials with overwhelming evidence; level III evidence includes observational trials; and level IV evidence includes anecdotal evidence or expert opinion.

    • ↵† Grade A recommendations are strong; grade B recommendations are intermediate; and grade C recommendations are weak.

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Canadian Family Physician: 59 (5)
Canadian Family Physician
Vol. 59, Issue 5
1 May 2013
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Risk assessment for physical activity and exercise clearance
Shannon S.D. Bredin, Heather J.A. Foulds, Jamie F. Burr, Sarah A. Charlesworth
Canadian Family Physician May 2013, 59 (5) 515-517;

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Shannon S.D. Bredin, Heather J.A. Foulds, Jamie F. Burr, Sarah A. Charlesworth
Canadian Family Physician May 2013, 59 (5) 515-517;
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