Sport and exercise recommendations for pregnant athletes: a systematic scoping review

Figures

• 

  Figure 1. Flow chart of the study selection process (25 February 2022).

• 

  Figure 2. Flow chart of the update-search study selection process (8 September 2022).

• 

  Figure 3. Evidence mapping: outcome parameters are presented according to the level of evidence of the study type and the number of female athletes. (The number of studies is given in the parentheses except for the case studies, as here the number results from the study type. In the two studies by Szymanski et al, the data were given for the same study population.57 59 This results in the same number of female athletes (62) with the same number of studies.) IUGR, intrauterine growth restriction.

• 

  Figure 4. These data were extracted from a prior original study58 and are from six pregnant women before, during and after exercise. After a warm-up for 10 min (maternal heart rate (mHR) of ~135/min), the women ran three to five submaximal workloads (test 1 to test 5; 5 min each) on a treadmill with a VO2max (maximal oxygen consumption) of 60%–90%. Fetal heart rate (fHR) in beats per minute (data points in blue) and umbilical artery pulsatility index (PI) (data points in green) were measured before exercise, after warm-up, during (test 1 to test 5) and after exercise. Three women completed only three workloads, one woman completed four workloads and one woman completed even five workloads. An increase in PI and a drop in fHR could be observed in the two women (woman 5 and woman 6) who completed four or five workloads each. Woman 5 exercised at 95% of maximal mHR and woman 6 exercised at 92% maximal mHR. These results imply that exercise intensity over 90% of maximal mHR may have a negative impact on fetal well-being.