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Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC expert group meeting, Lausanne. Part 4—Recommendations for future research
  1. Kari Bø1,
  2. Raul Artal2,
  3. Ruben Barakat3,
  4. Wendy J Brown4,
  5. Gregory A L Davies5,
  6. Mike Dooley6,
  7. Kelly R Evenson7,8,
  8. Lene A H Haakstad9,
  9. Bengt Kayser10,
  10. Tarja I Kinnunen11,
  11. Karin Larsén12,
  12. Michelle F Mottola13,
  13. Ingrid Nygaard14,
  14. Mireille van Poppel15,
  15. Britt Stuge16,
  16. Karim M Khan17
  1. 1 Department of Sport Medicine, Norwegian School of Sport Science, Oslo, Norway
  2. 2 Department of Obstetrics/Gynecology and Women’s Health, Saint Louis University, St Louis, Missouri, USA
  3. 3 Facultad de Ciencias de la Actividad Física y del Deporte—INEF, Universidad Politécnica de Madrid, Madrid, Spain
  4. 4 Centre for Research on Exercise Physical Activity and Health, School of Human Movement, Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
  5. 5 Department of Maternal-Fetal Medicine, Queen’s University, Kingston, Ontario, Canada
  6. 6 Department of Sport Gynaecology, The Poundbury Clinic Dorchester—The Poundbury Suite, King Edward VII Hospital, London, UK
  7. 7 University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  8. 8 Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
  9. 9 Department of Sport Sciences, Norwegian School of Sport Science, Oslo, Norway
  10. 10 Faculty of Biology and Medicine, Institute of Sport Science, University of Lausanne, Lausanne, Switzerland
  11. 11 Faculty of Social Sciences/Health Sciences, University of Tampere, Tampere, Finland
  12. 12 The Swedish School of Sport and Health Sciences, Stockholm, Sweden
  13. 13 R. Samuel McLaughlin Foundation—Exercise and Pregnancy Lab, The University of Western Ontario, London, Ontario, Canada
  14. 14 Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
  15. 15 Institute of Sport Science, University of Graz, Graz, Austria
  16. 16 Division of Orthopaedic Surgery, Oslo University Hospital, Ullevål, Oslo, Norway
  17. 17 Department of Family Practice and School of Kinesiology, Centre for Hip Health and Mobility, University of British Columbia, Vancouver, Canada
  1. Correspondence to Professor Kari Bø, Department of Sport Medicine, Norwegian School of Sport Science, Oslo 0806, Norway;{at}

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This is Part 4 in the series of reviews from the International Olympic Committee (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 experienced by athletes;1 Part 2 addressed maternal and foetal perinatal outcomes;2 Part 3 reviewed the implications of pregnancy and childbirth on return to exercise and on common illnesses and complaints in the postpartum period.3 Parts 1–3 are all open access papers.

In Part 4, we recommend future research based on Parts 1–3. The systematic reviews, on which the previous Parts were based, revealed many gaps in knowledge relating to strenuous exercise during pregnancy and in the postpartum period, in both regular recreational exercisers and elite athletes. Important research questions are listed below, in relation to the foci of Parts 1–3, under the following headings: exercise during pregnancy, exercise related to birth outcomes and exercise in the postpartum period. References to existing research in the respective areas are listed in the previously Parts 1–3 and are not repeated here.

Research questions related to exercise during pregnancy

(based on the review of the effects of training during pregnancy and on the management of common pregnancy-related complaints experienced by recreational and elite athletes1).


  • Are athletes of reproductive age concerned about that their fertility may be limited?

    • Does duration and frequency of strenuous exercise impact fertility?

  • Do factors that affect fertility differ in elite athletes and the general population (including recreational athletes, active and sedentary women)?

Medical conditions

  • Does the prevalence of, and risk factors for, the following …

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.