Table 2

Specific classifications of pre-existing contraindications to prenatal physical activity

Absolute contraindicationRelative contraindication
Avoid MVPA, but maintain activities of daily livingCould be recommended MVPA, with or without modifications, and should maintain activities of daily livingPotential modifications
Respiratory disorders
COPD Severe:
GOLD 3 or 4
Remain physically active below threshold of intolerance
Asthma Severe:
FEV1 <60%, daily oral corticosteroid use
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
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
Lowmoderate intensity activity
Smoking Moderate–heavy (≥20 cigarettes per day) with comorbidities:
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.