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Medical Journal of Obstetrics and Gynecology

Review Article

Influence of Exercise Mode on

Maternal, Fetal, and Neonatal
Health Outcomes
Moyer C1 and May L2*
Department of Health and Human Sciences, Bridgewater College, USA
2
Department of Foundational Sciences and Research, East Carolina University, USA
1

Abstract
Research has demonstrated aerobic exercise is safe and beneficial for mother,
fetus, and neonate. Unlike aerobic exercise, little research has focused on the effects
of resistance training during pregnancy. Preliminary studies have shown that acute
resistance training is safe for pregnant women. It has been found to be effective in
increasing lean body mass in pregnant woman. Research studying chronic resistance
training during pregnancy has focused on delivery outcome rather than examining the
chronic health effects or adaptations of resistance training exposure for the expectant
mother. Additionally, scarce research has been done to examine the effects of acute
maternal resistance training on the fetus, except to conclude that the fetus is not at an
increased risk of distress during maternal resistance exercises.

*Corresponding authors
Linda May, Department of Foundational Sciences
and Research, East Carolina University, USA, Tel: 252737-7072; Fax: 252-737-7049; E-mail:
Submitted: 05 August 2014
Accepted: 21 August 2014
Published: 23 August 2014
ISSN: 2333-6439
Copyright
2014 May et al.
OPEN ACCESS

Keywords
Pregnancy
Aerobic
Resistance
Circuit
Target heart rate

Some researchers have studied circuit (aerobic and resistance) training on acute
maternal responses or chronic adaptations during pregnancy. In response to prolonged
circuit training during pregnancy, women who exercised more were less likely to have
a Cesarean delivery and spent less time recovering in the hospital. Furthermore,
research has not been completed on the fetal responses or adaptations as a result of
acute or chronic maternal circuit training throughout pregnancy, except to report that
birth weights are similar between exercising and control groups. Logically, if aerobic
and resistance exercise programs individually are safe for the pregnant woman and
her fetus, then a combination program would also be safe. Clearly, more research
is needed and this article will summarize our current state of knowledge regarding
exercise during pregnancy.

ABBREVIATIONS

Guidelines for aerobic exercise

ACSM: American College of Sports Medicine; ACOG:

American Congress of Obstetrics and Gynecology; SOGC: Society of
Obstetricians and Gynaecologists of Canada; CSEP: Canadian Society
for Exercise Physiology; HR: heart rate; HRV: heart rate variability;
HF: high frequency power in frequency domain of HRV; VO2:
oxygen consumption.

The recommendations for aerobic exercise prescription during

pregnancy published by the ACSM, ACOG, SOGC, and CSEP fully
agree and cross-reference one another. These recommendations begin
with clearance by a physician to participate in exercise. If a pregnant
woman is healthy and has a low-risk pregnancy (i.e. no contraindications for exercise as listed in (Table 1), then she should participate in
moderate intensity aerobic exercise for at least 30 minutes most days
of the week, with a goal of 150 minutes per week [1-5]. Previously
sedentary, overweight and obese pregnant women are encouraged to
begin with 15 minutes per exercise bout and gradually increase to the
recommended 30 minutes [1-5]. Moderate intensity has been defined
as approximately 60-80% of maximum heart rate or target heart rate
zone (Table 2), 12-14 on the Borg scale rating of perceived exertion
(Table 3), or by using the talk test, which means being able to converse while exercising without feeling short of breath [2,4-8]. Since
pregnancy involves numerous physiological and anatomical changes,
target heart rate (Table 2) zones for non-gravid women are not sufficient to meet the physiological demands of the pregnancy. Due to this

INTRODUCTION
The purpose of this article is to compare the effects of aerobic,
resistance, and circuit training throughout pregnancy on maternal
and fetal physiological adaptations. The contents of this text will
expound on the available literature and its applicability to pregnant
patients. Topics discussed include: guidelines for aerobic exercise
during pregnancy, maternal and fetal responses to aerobic exercise,
offspring measures related to aerobic exercise, maternal and fetal
responses to resistance training, and maternal and fetal responses to
circuit training during pregnancy.

Cite this article: Moyer C, May L (2014) Influence of Exercise Mode on Maternal, Fetal, and Neonatal Health Outcomes. Med J Obstet Gynecol 2(2): 1036.

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Table 1: Contraindications to aerobic exercise during pregnancy.
Adopted from ACSMs guidelines for exercise testing and prescription. 8th
ed. Philadelphia (PA): Wolters Kluwer and Lippincott Williams & Wilkins;
2010. p. 185.
Absolute Contraindications to
Aerobic Exercise During
Pregnancy
Hemodynamically significant
heart disease

Relative Contraindications to
Aerobic Exercise During
Pregnancy

Incompetent cervix/cerclage

Chronic bronchitis

Restrictive lung disease

Multiple gestation at risk for

premature labor
Persistent second or third
trimester bleeding
Placenta previa after 26 weeks
gestation
Premature labor during the
current pregnancy

Severe anemia

Unevaluated maternal cardiac

arrhythmia
Poorly controlled type I diabetes
Extreme morbid obesity

Extreme underweight (body mass

index <12)
History of extremely sedentary
lifestyle
Intrauterine growth restriction in
Ruptured membranes
current pregnancy
Poorly controlled hypertension/
Pregnancy induced hypertension
preeclampsia
Orthopedic limitations

Poorly controlled seizure disorder

Poorly controlled thyroid disease
Heavy smoker

Table 2: Modified target heart rate zones developed for normal,

overweight, and obese pregnant women.
Modified Target Heart Rate Zones for Pregnant Population
Age

Normal Weight

< 20 years old

140-155

20-29 years old

30-39 years old

> 40 years old

Overweight & Obese

135-150

110-131

130-145

108-127

125-140

Table 3: Borg RPE Scale. Adapted from Borg GA. Psychophysical bases of
perceived exertion. Med Sci Sport Ex. 1982; 14: 377-81.
Borg Scale for Rating of Perceived Exertion (RPE)
6
7
8
9

10
11
12
13
14
15
16
17
18
19
20
Med J Obstet Gynecol 2(2): 1036 (2014)

Very, very light

Very light

Fairly light

Somewhat hard
Hard

Very hard

Very, very hard

physiological phenomenon, target heart rate zones for normal weight,

overweight and obese pregnant women have been developed and are
listed in (Table 2) [5,7,8]. Also, HR is the most accurate measure of
intensity, especially for women who have trained prior to pregnancy
[9]. The goal of exercise during pregnancy is to maintain or increase
fitness and avoid maximal exertion [5, 10,11]. To achieve this goal, it
is currently recommended to utilize aerobic types of exercise such as
walking, cycling, and swimming [1-3, 5,12]. Pregnant women should
avoid activities that increase their risk of losing balance or could result in fetal trauma, such as ball-sports and recreational activities like
skiing, biking outside, horseback riding, etc.[1-3,5,12]. Overall, these
recommendations are similar to those for non-gravid populations as
published by the ACSM [3]. Previously sedentary, overweight and
obese non-gravid individuals should exercise at a light to moderate
intensity (57-75% HRmax), 20-30 minutes a day, most days of the week
[3].

Maternal responses to aerobic exercise

Aerobic exercise during pregnancy provides as many health
benefits as in non-pregnant populations [13-15]. Benefits range from
improvements in cardiovascular functioning, metabolic functioning,
weight management, and mental health functions acutely and after
prolonged periods of exercise training. Though gravid women
experience similar benefits to exercise as the adult population, their
acute responses to exercise are slightly different when compared to
pre-pregnancy values because of the physiological and anatomical
changes associated with pregnancy (Table 3)[3]. As in non-pregnant
populations, pregnant women of all BMI classifications experience
adaptations, such as improvements in resting heart rate (HR)
and cardiac output (Q), in response to chronic aerobic exercise
[12,16,17]. Blood pressure (BP) does not significantly change
throughout the course of pregnancy between women who exercise
throughout pregnancy and those who do not, regardless of the level
of intensity [16,18]. Santos et al found that aerobic submaximal
capacity is improved in overweight pregnant women after an aerobic
exercise training program. The regulation of insulin, glucose, and
blood lipids is also improved in pregnant women who participate in
aerobic exercise [4,12,16], as in non-gravid populations [14]. Body
composition measures also change, such as decreased fat deposition,
in response to aerobic exercise during pregnancy similar to the nonpregnant population [12-16]. Gestational weight gain is much more
variable for overweight and obese pregnant women participating in
an exercise program [15, 17, 19]. In addition, previously sedentary
women who begin an exercise program during pregnancy experienced
improved cardiovascular function, improved body composition,
and less weight gain during pregnancy, thus decreasing their risk of
developing gestational diabetes mellitus and hypertension [7].
Ruchat et al. [20] utilized a light intensity and moderate intensity
aerobic exercise program coupled with a nutrition intervention in
normal weight pregnant women. Although participants gained excess
pregnancy weight prior to the start of this intervention, women in the
exercise groups gained significantly less weight throughout the entire
course of their pregnancy than women in the control group. Despite
this finding in the exercising groups, neonate weight, length, and BMI
did not significantly differ between groups [20]. Mottola et al. [21]
employed a similar exercise and nutrition intervention in overweight
and obese pregnant women. No significant differences were found for
total weight gained between the groups [21]. The amount of weight

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gained over the course of the pregnancy was within the acceptable
range and not in excess, according to guidelines published by a
Canadian health initiative. Weight gain of the intervention groups
was not compared to matched normal-weight controls.
Management of gestational weight gain is important in preventing
the development of gestational diabetes mellitus and hypertension
in pregnancy, preventing delivery complications and adverse fetal
outcomes, and decreasing the amount of weight retained post-partum
[4, 20-23]. Rossner [24] found that weight gain during pregnancy was
the most significant predictor of weight retention 1 year postpartum.
Weight retention can have adverse effects for the woman, increasing
her susceptibility to various disease states, as well as adverse fetal
health outcomes in future pregnancies. Edwards et al. [25] reported
that excess gestational weight gain may have greater consequences for
neonatal health than maternal health in normal weight, overweight
and obese pregnant women. Oken et al. [23] further supported this
claim, finding that excess gestational weight gain related directly
to infant and childhood weight statuses. They found that excess
gestational weight gain resulted in increased child adiposity at age 3
in normal weight, overweight and obese pregnant women [23]. Thus,
the management of weight gained during pregnancy is important to
improving maternal, neonatal, and childhood health and well-being.
These improvements in maternal health during pregnancy
contribute to overall improved health post-partum, decreased risk of
adverse conditions, and improved outcomes in future pregnancies.
Aerobic exercise positively influences pregnancy outcome by
decreasing complications for both mother and baby during labor and
delivery, including a decreased need for Cesarean section delivery
and decreased hospitalization time for maternal recovery [26-28].
Since pregnant women respond and adapt to exercise in a similar
manner, the ensuing health benefits are likely to be similar regardless
of weight classification and parity.

Fetal responses to aerobic exercise

Previous research has shown fetal adaptations in response
to maternal aerobic exercise [29-33]. Szymanski and Satin [33]
monitored fetal HR before, during, and after single moderate and
vigorous intensity exercise sessions. Fetal HR increased post-exercise
in both groups, but did not exceed normal limits [33]. Ultrasound was
also used to monitor the fetus before and after exercise sessions with
no adverse outcomes noted. These results indicate that acute maternal
aerobic exercise of moderate or vigorous intensity is tolerated by
the fetus. Other studies have also reported no signs of fetal distress
in response to acute maternal aerobic exercise. Kennelly et al. [34]
measured fetal HR and variability before and after a single maternal
aerobic exercise test in overweight pregnant women. No significant
change in fetal HR occurred during the exercise test [34]. However, a
significant difference in HRV was noted between pre and post exercise
measures. These results suggest that a single bout of high intensity
maternal aerobic exercise does not increase the risk of fetal distress.
Clapp et al. [35, 36] measured amniotic erythropoietin levels to
determine if regular maternal aerobic exercise throughout pregnancy
induces a fetal hypoxic effect. Results indicated that erythropoietin
levels were not significantly different between exercising women
and non-exercising controls, further suggesting that the fetus is not
in danger of chronic hypoxia or bradycardia as a result of chronic
maternal aerobic exercise [35,36].
Med J Obstet Gynecol 2(2): 1036 (2014)

Multiple studies [29-31,37-40] have found that measures of fetal

HRV increase with gestational age. Multiple studies have found
that offspring of exercising pregnant women do not significantly
differ in birth size (i.e. length, abdominal circumference) compared
to offspring of women who do not exercise throughout pregnancy.
Two studies completed by Clapp [41] and Clapp et al.[42] reported
that, at birth, neonates of exercising mothers weighed less due to less
body fat percentage and total body fat mass than neonates of controls
[41, 42]. However, there was no significant difference found in lean
body mass between the offspring of each group [41, 42]. Szymanski
and Satin [33] found that birth weight was not significantly different
between neonates of exercising pregnant women and controls.
Ruchat et al. [20] found that offspring of normal weight pregnant
women who participated in an exercise and nutrition intervention
did not significantly differ in regards to birth weight and BMI among
maternal intervention groups (light intensity, moderate intensity,
and control). A similar study employing overweight and obese
pregnant women also found that birth weight of offspring did not
differ significantly between overweight and obese pregnant women
or between exercising women and matched controls from a local
medical database [21]. Each of these studies provides evidence that
fetuses of exercising pregnant women, of any weight classification,
are likely to have a normalized birth weight.

Maternal responses to resistance training

Studies have demonstrated that participation in resistance
training during pregnancy is safe (56), and women felt better about
themselves, gained less weight, and felt relief from somatic problems
(i.e. nausea, fatigue, headache) [43]. As pregnancy progressed, the
intensity of exercise decreased [43]. Further studies found resistance
with aerobic exercise is associated with decreased prevalence of
hypertension and diabetes during pregnancy relative to aerobic only
or controls [44]. Resistance exercise during pregnancy also decreases
patients with GDM that need insulin and improves glycemic control
[45, 46]. Studies show no adverse pregnancy outcomes associated with
resistance training during pregnancy [47]. Women may experience
increased strength and flexibility from participating in resistance
exercise while pregnant [47]. OConnor et al. [11] employed a 12
week, low-to-moderate intensity resistance training program in 32
pregnant women. The purpose of the study was to determine the
safety and efficacy of a strength program to decrease low back pain
and to determine the rate of musculoskeletal injury due to resistance
training during pregnancy. The program consisted of six different
exercises focusing on legs, arms, back, and abdomen. Intensity was
maintained by using the 6-20 Borg scale of perceived exertion, which
was also applied to help progress the external load of each exercise
completed. The average external load increased progressively over
the 12 week period, which suggests an increase in maternal strength
over time, although no assessments were completed to substantiate
this claim. No injuries were reported over the 12 week program,
but the primary symptom reported was dizziness [11]. There was
also no significant change in maternal resting BP noted from the
beginning to the end of the 12 week program [11]. OConnor et al.
[11] emphasized and recommended education of proper breathing
and lifting techniques and general muscular conditioning throughout
the 12 week program.
Resistance training is a mode of exercise employed by many
individuals to maintain or increase muscle strength and has grown

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in popularity among many different populations. However, in the
pregnant population, only a few studies have analyzed the acute and
chronic effects of resistance training on the mother and fetus [7, 1012, 48]. Preliminary studies have shown that acute resistance training
can be safe and efficacious for the mother and her unborn child
[7, 10, 11, 48]. Avery et al. [48] measured maternal HR and BP in
response to strength exercises during the third trimester. During each
session (at 31, 32, and 33 weeks gestation), participants completed
hand grip, single leg extension, and double leg extension exercises in
seated and supine positions with varying intensity levels. Maternal
HR and BP were measured with each increase in intensity for both
positions of the aforementioned exercises. The measured responses
to strength training in pregnant women were similar to those of nonpregnant controls, with no differences in BP at rest and during each
exercise [48]. BP in both groups was greatest when larger muscle
groups were utilized, while HR was only elevated in pregnant women
[48]. OConnor et al. [11] also reported no significant difference in
maternal BP before and after acute maternal resistance training of 6
different strength exercises. This unaltered measurement of BP before
and after acute resistance exercise during pregnancy is the same as
noted in response to acute aerobic exercise [16, 49].
A case study completed in a single obese pregnant woman
investigated the use of progressive resistance training throughout the
2nd and 3rd trimesters [50]. The participant completed a combination
of upper and lower body exercises three times a week. The pregnant
mother maintained a moderate intensity, regulated by her heart rate.
Over the course of the program, the participant gained lean body
mass, decreased BMI, and increased training volume by 58% [50].
It appears from these results that moderate intensity progressive
resistance training throughout pregnancy is safe and beneficial to
maternal health. Similarly, Barakat et al. [51] reported no significant
difference in maternal gestational weight gain or type of delivery in
normal weight pregnant women in response to chronic light intensity
resistance training. No adverse health outcomes or injuries were
reported during the training period.
These responses in the pregnant population are similar to those
reported in non-gravid populations [52, 53]. Dionne et al. [52]
reported increased fat free mass and resting energy expenditure
in normal weight non-pregnant women after a 6 month resistance
training program. Donges and Duffield [53] reported increased
fat free mass and decreased fat mass in overweight non-pregnant
women after 10 weeks of either resistance training or aerobic
training programs. Therefore, because gravid and non-gravid women
experience similar responses and adaptations to aerobic exercise, it
can be surmised that they will have similar responses and adaptations
as a result of acute and chronic resistance exercises and training.
These results are due to the average external load increased
progressively over the 12-week period, which suggests an increase in
maternal strength over time, although no assessments were completed
to substantiate this claim. Similarly, Barakat et al. [51] reported no
significant difference in maternal gestational weight gain or type of
delivery in normal weight pregnant women in response to chronic
light intensity resistance training. No adverse health outcomes or
injuries were reported during the training period.
Abdominal (core) training is important resistance exercise that
helps keep abdominal muscles strong (for delivery), but a study found
prenatal or postnatal abdominal exercises helps reduce diastasis
Med J Obstet Gynecol 2(2): 1036 (2014)

recti [54]. These responses in the pregnant population are similar

to those reported in non-gravid populations [52, 53]. Dionne et al.
[52] reported increased fat free mass and resting energy expenditure
in normal weight non-pregnant women after a 6 month resistance
training program. Donges and Duffield [53] reported increased
fat free mass and decreased fat mass in overweight non-pregnant
women after 10 weeks of either resistance training or aerobic training
programs. Regardless of whether a woman participates in aerobic
only, aerobic + resistance training, or control group, there are no
differences in preterm labor, mode of delivery, and gestational age
[44].

Fetal responses to resistance training

In the aforementioned study by Avery et al. [48], fetal HR
was measured before, during, and after each maternal resistance
exercise, with no significant changes in fetal HR observed. This study
concluded that the fetus tolerates acute maternal strength exercise
well and that acute maternal strength exercises do not cause fetal
distress before, during, or after. This agrees with a retrospective
study that found frequency, intensity, and time measures related
to resistance training were inversely related to fetal complications,
such that increased resistance training was associated with decreased
likelihood of fetal complication during pregnancy [55]. However,
the primary recommendation of this study is for pregnant women
to avoid supine exercises in the third trimester as it may increase
the risk of fetal hypoxia and bradycardia due to increased maternal
BP and decreased blood flow to the fetus [48]. Barakat et al. [51]
reported increased fetal HR in response to light intensity maternal
resistance exercises. This response indicates that the acute fetal HR
response to maternal resistance exercises is normal and similar to the
response reported when exposed to acute maternal aerobic exercise.
These results further substantiate the claim that the fetus is not at an
increased risk of distress or adverse health outcomes in response to
acute maternal exercise, regardless of the type and intensity.
Although many studies have reported no negative or adverse
pregnancy outcomes as a result of maternal resistance training [11,
56, 57], none of these studies have completed measures of fetal
health in response to chronic maternal resistance training. Therefore,
very little is known about the long term effects of chronic maternal
resistance training on fetal and neonatal health, even though it
appears to be safe. Post-hoc analyses (unpublished data) show that
intermittent maternal exercises (i.e. strength training) correlates with
increased overall HRV, whereas continuous maternal exercise (i.e.
aerobic) correlates with increased HF (a parasympathetic measure).
These analyses suggest that different modes of maternal exercise
have different effects on the developing cardiovascular system.
Additionally, there is no research regarding the influence of acute
or chronic maternal resistance training in overweight and obese
pregnant women. Although the subjects participating in Dr. Mays
previous study represent all weight classifications, the study was not
specifically designed to look at the effects of overweight and obese
pregnant mothers exercise on fetal heart outcomes. There are also
no generally accepted guidelines or recommendations for resistance
training during pregnancy to accompany those for aerobic exercise.
Unfortunately, the present literature is lacking in this area while there
is a growing interest in providing research-based resistance training
recommendations to pregnant populations.

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Maternal responses to circuit training

The combination of aerobic and resistance training has become
more popular among healthy, non-gravid populations. Aerobic
training is known to increase cardiovascular and pulmonary health
while resistance training results in increased muscular strength and
endurance. Research on the acute responses and chronic adaptations
in maternal and fetal health of combining these modes of exercise
has not been sufficiently addressed in the pregnant population.
Acute responses of maternal health due to participation in circuit
training during gestation have not been reported. However, nongravid participants in a single session of circuit training experienced
decreased systolic and diastolic BP, stroke volume, and cardiac
output and increased systemic vascular resistance and HR compared
to control values, acute aerobic training only, and acute resistance
training only [58].
Few studies have measured maternal chronic adaptations and
maternal health outcomes in response to circuit training during
pregnancy. A study by Hall and Kaufmann [26] explored pregnancy
outcomes after a combination training exercise regimen throughout
pregnancy. This regimen consisted of a 3-5 minute warm-up, followed
by individually prescribed strength and flexibility exercises, and
ended with a 1-2 mile cycling workout. Exercise groups were divided
into low, medium, and high according to the number of exercise
sessions completed throughout the course of pregnancy. Women who
completed more exercise sessions were less likely to have a Cesarean
section than women who exercised less or not at all (Med/Hi > Low/
Control). Additionally, women who exercised spent less time in the
hospital after delivery compared to non-exercise controls. Price et
al. [28] measured cardiorespiratory fitness, strength, and flexibility
in overweight pregnant women participating in a circuit training
program throughout the 2nd and 3rd trimesters. At each testing session
(every 6 weeks from 12 wks GA to 8 wks postpartum), the exercising
groups had higher cardiorespiratory fitness, measured by power
produced during a 2 mile walk, than controls, with a significant
difference at 30-32 weeks gestational age [28]. Exercising pregnant
women had significantly higher strength, measured by a 7kg lift test,
than controls from 18 weeks gestational age to 8 weeks postpartum
[28]. Flexibility measures were not significantly different between
groups. Significantly fewer women in the exercise group delivered
via Cesarean section than controls and time to recovery postpartum
was significantly shorter as well [28].Circuit training combining
aerobic and resistance exercise leads to adaptive benefits of the
placenta [59]. This adaptation of the vascular system reduces the risk
of pre-eclampsia, diabetes, and hypertension while pregnant [59]. It
is suggested that HR is more accurate for gauging exercise intensity
during weight-bearing exercise while pregnant [9].

Fetal responses to circuit training

Very few studies have researched the effects of maternal circuit
training on fetal health. A retrospective analysis found that overall
women decrease their level of aerobic and resistance exercise during
pregnancy, and most importantly maternal and fetal complications
occur at a rate similar to the general population [55]. Hall and
Kauffman [26] found no significant differences in birth weight of
offspring among groups. However, a significant difference was found
in 1 and 5-minute APGAR scores of offspring among groups, with
those of women who completed the most exercise sessions having a
Med J Obstet Gynecol 2(2): 1036 (2014)

higher score. Price et al. [28]. also reported no significant differences

in birth weight between exercise and control groups. Although little
has been reported as far as acute or chronic fetal health measures in
response to maternal circuit training, based on the available data this
type of exercise is also safe during pregnancy.
Since other studies have shown that pregnant populations have
similar acute and chronic aerobic and resistance exercise training
responses as non-gravid populations, one can postulate that pregnant
populations will also benefit from the use of combination training
regimens similar to their non-gravid counterparts. Although
preliminary studies have shown that resistance training and aerobic
training do not adversely affect fetal development individually, the
effects on fetal health outcomes from combining these two modes of
exercise warrants further investigation, especially in overweight and
obesemothers.

DISCUSSION AND CONCLUSION

Various types of exercise throughout pregnancy have been
proven safe and efficacious for the mother and her unborn child.
Although a popular belief remains that women who are not
previously active should refrain from beginning regular exercise
during pregnancy, a plethora of research has refuted this claim.
Moderate intensity aerobic exercise is safe and recommended for
improved maternal and fetal health outcomes such as cardiovascular
health, management of gestational weight gain, prevention of chronic
diseases, neonatal morphometric, and childhood health measures.
Resistance and circuit training has grown in popularity among nongravid populations, but currently remains inadequately researched
regarding pregnancy. More research is needed to determine if these
modes of exercise provide any long-term benefit to maternal, fetal,
and/or neonatal health. Additionally, little research has focused on
overweight and obese pregnant women who, like their non-gravid
counterparts, appear to significantly benefit from participation in a
regular moderate intensity exercise program throughout gestation.
Studies are currently being done to address many of these unanswered
questions related to maternal and fetal health and exercise during
pregnancy.

ACKNOWLEDGEMENTS
We would like to thank East Carolina University for their internal
funds to support the continued work in the area of exercise and
pregnancy.

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Cite this article

Galaal K, Brook A, Smits A, Lopes AD (2014) Intraoperative Cell Salvage in Surgery for Ovarian Cancer: Time for Action. Med J Obstet Gynecol 2(2): 1035.

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