Specific classifications of pre-existing contraindications to prenatal physical activity
| Absolute contraindication | Relative contraindication | ||
| Avoid MVPA, but maintain activities of daily living | Could be recommended MVPA, with or without modifications, and should maintain activities of daily living | Potential modifications | |
| Respiratory disorders | |||
| COPD |
Severe: GOLD 3 or 4 | Remain physically active below threshold of intolerance | |
| Asthma |
Severe: FEV1 <60%, daily oral corticosteroid use Symptomatic | Remain physically active below threshold of intolerance | |
| Cystic fibrosis |
Severe: FEV1 <50% Clinically unstable Worsening disease status Presence of Burkholderia cepacia or MRSA | Remain physically active below threshold of intolerance | |
| Restrictive lung disease |
Severe: FEV1 <60% | Remain physically active below threshold of intolerance | |
| Type 1 diabetes |
Uncontrolled: Unpredictable or frequent hypoglycaemia Presence of comorbidities: Uteroplacental insufficiency Fetal growth restriction Hypertensive disorders Chronic renal disease | Well controlled | Use of continuous glucose monitor and/or insulin pump to improve glycaemic control. Educated about precautionary measures to avoid postexercise and nocturnal hypoglycaemia |
| Congenital heart disease |
Severe: NYHA functional class III or IV |
Mild–moderate: NYHA I or II | Exercise below threshold of intolerance |
| Arrhythmia |
Symptomatic or severe: Symptoms including (pre)syncope, onset of ventricular premature beats, exertional fatigue Severe conditions, for example, ventricular tachycardia, implantable defibrillators Contraindicated from exercise prior to pregnancy | Low–moderate intensity activity | |
| Smoking |
Moderate–heavy (≥20 cigarettes per day) with comorbidities:
IUGR Hypertensive disorders | ||
| Eating disorders |
Symptomatic: Inadequate GWG Exhibiting restrictive or compensatory behaviours Reduced fetal growth | Prescribe low-intensity activity within current recommendations (ie, 150 min/week) | |
COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume; GOLD, Global Initiative for Chronic Obstructive Lung Disease; GWG, gestational weight gain; IUGR, intrauterine growth restriction; MRSA, Methicillin-resistant Staphylococcus aureus; MVPA, moderate to vigorous physical activity; NYHA, New York Heart Association.