The key to achieving euglycemia through exercise is ensuring the adequate duration and intensity of the activity. At least half an hour of brisk walking per day is sufficient to upregulate insulin sensitivity, obviating the need for insulin therapy.
Weight Control
Although exercise should never be used for weight control during pregnancy, excessive weight gain should be avoided.
The current Institute of Medicine (IOM) guidelines on weight gain—which recommend a gain of 25–35 pounds for normal-weight women with a singleton pregnancy—are too high and are based on historical concerns about the effects of famine on fetal growth retardation.
The effect of gestational weight gain on pregnancy outcomes in obese women is not well studied. “It is my opinion that the IOM guidelines are outdated, and that weight gain recommendations should be individualized,” he noted.
Postpartum Exercise
Because failure to lose weight gained in pregnancy is a significant contributor to the obesity epidemic, the promotion of good exercise habits during pregnancy can also sow the seeds for postpartum exercise and weight loss.
In a study by Dr. Artal and colleagues, a weekly structured exercise program plus diet in postpartum overweight women were found to be much more effective in achieving weight loss after 12 weeks, compared with a single 1-hour education session about diet and exercise (J. Women's Health [Larchmt] 2003;12:991–8).
Staying hydrated is key, as sweating may compromise heat dissipation. Lynda Banzi
Contraindications To Exercising During Pregnancy
Absolute Contraindications
Hemodynamically significant heart disease
Restrictive lung disease
Incompetent cervix/cerclage
Multiple gestation at risk forpremature labor
Persistent second- or third-trimester bleeding
Placenta previa after 26 weeks'gestation
Premature labor during the current pregnancy
Ruptured membranes
Preeclampsia/pregnancy-induced hypertension
Relative Contraindications
Severe anemia
Unevaluated maternal cardiac arrhythmia
Chronic bronchitis
Poorly controlled type 1 diabetes
Extreme morbid obesity
Extreme underweight (body massindex [kg/m
History of extremely sedentary lifestyle
Intrauterine growth restriction in current pregnancy
Poorly controlled hypertension
Orthopedic limitations
Poorly controlled seizure disorder
Poorly controlled hyperthyroidism
Heavy smoker
Source: Obstet. Gynecol. 2002;99:171–3