Table 1

Absolute and relative contraindications to prenatal exercise in guidelines from around the world

ContraindicationSOGC/CSEP1–3 IOC7 ACOG6 SMA5
Cardiovascular disorders
 Serious cardiovascular disorderXHaemodynamically significantHaemodynamically significant
 Chronic hypertension, uncontrolledXX
 Hypertensive disorders of pregnancyX
 Gestational hypertensionXX
Respiratory disorders
 Serious respiratory disordersX
 Restrictive lung diseaseXX
Pregnancy-specific disorders
 IUGRXXGrowth-restricted fetus
 Multiple pregnanciesHigh order (≥3)Risk of PTLRisk of PTLHigh order (≥3)
 Persistent vaginal bleedingXT2 or T3T2 or T3
 Placenta previaAfter 28 weeksAfter 26 weeksAfter 26 weeksAfter 28 weeks
 Preterm labour (including premature contractions)XXXSigns of
 Incompetent cervixXXX
 Cervical insufficiencyX
Other disorders
 Anaemia (severe)XX
 Systemic disorderX
 Thyroid disease, uncontrolledX
 Type 1 diabetes, poorly controlledX
Cardiovascular disorders
 Cardiac arrhythmia, unevaluatedXX
 Cardiovascular disorders, mild/moderateXX
 Chronic hypertension, uncontrolledXHypertension (all)
 Gestational hypertensionX
Respiratory disorders
 Mild/moderate respiratory disordersXXX
 Chronic bronchitisXX
 Smoking, heavy (>20 cigarettes/day)Heavy smoker (all quantities)
Pregnancy-specific disorders
 IUGRHistory ofXIn current pregnancy
 History of premature birthXXX
 Recurrent pregnancy lossXHistory of
 Previous spontaneous abortionHistory ofX
 Twin pregnancies >28 weeksXX
 Cervical enlargementX
Other disorders
 Epilepsy, poorly controlledSeizure disorderSeizure disorder
 Thyroid disease, uncontrolledHyperthyroidismHyperthyroidism
 Type 1 diabetes, poorly controlledXXX
 Orthopaedic limitationsXX
 Other significant medical conditionsXX
 AnaemiaSymptomaticXHb <100 g/L
 Eating disorderXExtreme underweightBMI <12 kg/m2 X
 MalnutritionXExtreme underweightBMI <12 kg/m2 X
 ObesityBMI >40 kg/m2 BMI >30 kg/m2
 History of extremely sedentary lifestyleX
  • Adapted from Evenson et al (2014).135

  • Guidance from the UK Chief Medical Officer states that exercise should be recommended to women with uncomplicated pregnancies.4 However, women with obstetric or medical complications may perform moderate intensity physical activity during pregnancy but should receive additional monitoring and/or specialist support.136

  • ACOG, American College of Obstetricians and Gynecologists; BMI, body mass index; CSEP, Canadian Society for Exercise Physiology; Hb, haemoglobin; IUGR, intrauterine growth restriction; PPROMs, preterm premature rupture of membrane; PTL, preterm labour; SMA, Sports Medicine Australia; SOGC, Society of Obstetricians and Gynaecologists of Canada; T2, second trimester; T3, third trimester.