Exercise Programs to Prevent Gestational Hypertension

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A group of pregnant women exercise using large exercise spheres.The Community Preventive Services Task Force (CPSTF) recommends exercise programs for pregnant women to reduce the development of gestational hypertension. This CPSTF finding is specific to one type gestational hypertension without the development of preeclampsia-eclampsia. The CPSTF recommendation is based on evidence from 17 studies identified in a systematic review published in 2017 (Margro-Malosso et al., 2017).

The exercise programs use a combination of components to engage women early in their pregnancy. They must include supervised exercise classes that meet at least three times per week with 30-60 minutes of moderate-intensity aerobic exercise; and/or walking sessions during which women walk 90-150 minutes per week or 11,000 steps per day. The exercise programs may also include supervised resistance training, or additional education or encouragement on physical activity, nutrition, and weight management.

In the United States, the rate of hypertensive disorders in pregnancy has substantially increased from 5.3 per 100 delivery hospitalizations in 1993 up to 9.1 per 100 delivery hospitalizations in 2014 (Data on Pregnancy Complications). There are four different types of gestational hypertensive disorders: chronic hypertension, gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension. This CPSTF finding is specific to one type gestational hypertension without the development of preeclampsia-eclampsia (Reproductive Health).

This CPSTF recommendation underscores the information found in the Physical Activity Guidelines for Americans (2nd Edition), which explains how physical activity during pregnancy supports cardiorespiratory fitness, reduces the risk of excessive weight gain and gestational diabetes, and reduces symptoms of postpartum depression. The CDC provides additional guidance on high blood pressure in pregnancy.

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References

Magro-Malosso E, Saccone G, Di Tommaso M, Roman A, Berghella V. Exercise during pregnancy and risk of gestational hypertension disorders: a systematic review and meta-analysis. Acta Obstetrica et Gynecologica Scandinavica 2017;96:921-31.