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This is part 5 in the series of reviews from the IOC expert committee on exercise and pregnancy in recreational and elite athletes. Part 1 focused on the effects of training during pregnancy and on the management of common pregnancy-related complaints that may be experienced by athletes1; part 2 addressed maternal and fetal perinatal outcomes2; part 3 reviewed the implications of pregnancy and childbirth on return to exercise and on common illnesses and complaints in the postpartum period.3 Part 4 provided recommendations for future research based on parts 1 through 3.4 In part 5, we summarise our recommendations for exercise during pregnancy and after childbirth in recreational exercisers and elite athletes experiencing healthy pregnancies. Part 5 also serves as a background for healthcare personnel to advise women who wish to stay active at a high level.
Most of the references to existing research in the respective research areas are listed in the previously published parts1–3 and are not repeated here. The recommendations are divided into exercise during conception planning, exercise during pregnancy, effect of exercise during pregnancy on birth outcomes and exercise after childbirth. The level of evidence supporting the majority of the recommendations is very low or low-to-moderate. Therefore, advice to elite athletes regarding exercise frequency, duration and intensity that is beyond current guidelines must be individualised with regular close observation of maternal and fetal well-being.
The optimal fertile age period for women coincides with peak performance for many athletes, and some athletes may have impaired fertility related to relative energy deficiency in sport (RED-S). In addition to normal preconception advice, we advise that elite athletes who wish to become pregnant, should discuss specific issues, including their age, body weight, body mass index (BMI), body composition (% body fat), history of menstrual …
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