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Aim: This review aimed to appraise clinical guidelines about exercise for women with gestational diabetes mellitus and summarize consensus and inconsistent recommendations. Background: Exercise is an effective non‐pharmacological therapeutic for gestational diabetes mellitus, but the variety of relevant clinical practice guidelines is confusing for healthcare professionals. Design: This is a systematic review of clinical practice guidelines. Data Sources: Websites of guideline development institutions, eight literature databases and organizations of obstetricians, gynaecologists, midwives, and medical sports associations were searched for guidelines published from January 2011 to October 2021. Review Methods: Two reviewers independently extracted recommendations. Four reviewers assessed guideline quality using the AGREE II instrument independently. Results: Fifteen guidelines were included. All women with diabetes are recommended to exercise during pregnancy. The consistent recommendations were for pre‐exercise screening, for 30 min per exercise session on 5 days of the week or every day after meals, exercise at moderate intensity, using aerobic and resistance exercise, and walking. The main non‐consistent recommendations included warning signs for women on insulin during exercise, minimum duration per session, intensity assessment, duration and frequency of sessions for strengthening and flexibility exercise and detailed physical activity giving birth. Conclusions: Guidelines strongly support pregnant women with diabetes to exercise regularly. Research is needed to make non‐consistent recommendations clear. Summary statement: What is already known about this topic? Gestational diabetes mellitus is strongly associated with a higher risk of short‐ and long‐term adverse maternal and fetus outcomes.Physical activity is a safe and beneficial non‐pharmacological treatment for gestational diabetes mellitus.The methodological rigour and quality of the physical activity guidelines for pregnant women with gestational diabetes mellitus are unclear. What this paper adds? Methodological rigour and quality of the physical activity guidelines for pregnant women with gestational diabetes mellitus were identified by AGREE II instrument.Consensus and non‐consistent recommendations of the physical activity guidelines for pregnant women with gestational diabetes mellitus were summarized. The implications of this paper: The consensus recommendations make it clear that health professionals should offer physical activity guidance to pregnant women with gestational diabetes mellitus.Non‐consistent recommendations offer opportunities for further research directions. [ABSTRACT FROM AUTHOR]

Physical activity during pregnancy has numerous health benefits for the woman and the foetus. The current study investigated physical activity engagement and its predictors among pregnant Chinese women during the first trimester. A total of 687 pregnant women completed the Pregnancy Physical Activity Questionnaire. Bivariate and multivariate logistic regression were used to analyse the data. The current physical activity guidelines were not met by 64.3% of respondents. Women with higher levels of physical activity self-efficacy (aOR = 0.96; 95% CI: 0.92–0.99) and social support (aOR = 0.95; 95% CI: 0.94–0.97) had lower odds of not meeting the current physical activity guidelines. Women who were aged < 35 years (aOR = 1.85; 95% CI: 1.02–3.34), had lower education (aOR = 1.63; 95% CI: 1.04–2.55), were primiparous (aOR = 11.03; 95% CI: 6.98–17.44), were unsure of their delivery mode (aOR = 2.32; 95% CI: 1.95–5.64), and those who had higher levels of pregnancy-associated discomfort (aOR = 1.10; 95% CI: 1.03–1.19) had higher odds of not meeting the current physical activity guidelines. The current study suggests that healthcare professionals should assess physical activity engagement during routine antenatal care and increase efforts to strengthen pregnant women's self-efficacy and social support to promote physical activity engagement during the first trimester. [ABSTRACT FROM AUTHOR]

Introduction: Physical activity is recommended for healthy pregnant women. Clinical practice guidelines vary with regard to initial time, duration, or type of physical activity that is recommended, which is confusing for health care professionals and pregnant women alike. This study aimed to appraise clinical guidelines relevant to physical activity for pregnant women and summarize consensus and discrepant recommendations. Methods: The websites of organizations that develop guidelines including those of obstetricians, gynecologists, midwives, and medical sports associations were searched in addition to 9 literature databases for the period from January 2010 through November 2020. Guidelines were included if they were published in a journal or on a website in English or Chinese; were labeled as a recommendation guideline, position paper, practice parameter, or consensus statement; and addressed physical activity for pregnant women. Two authors independently extracted recommendations. Four reviewers independently assessed guideline quality using the AGREE II instrument. Results: Thirteen guidelines met the inclusion criteria. The guidelines developed by the World Health Organization and the National Institute for Health and Clinical Excellence were deemed to have the highest methodological quality. The recommendations were consistent with regard to recommended exercise duration, frequency, intensity, and type of physical activity. The main discrepant recommendations included best tools for conducting pre‐exercise screening and assessing intensity of exertion. Guidelines also differ on optimal heart rate during exercise, when in pregnancy to initiate an exercise regimen, and duration or frequency of strengthening exercises. Discussion: Of the 13 guidelines, 2 were found to have good methodological quality. The recommendations that were consistent across the differing guidelines can support health care providers in counseling women about physical activity during pregnancy. The recommendations that are discrepant among these guidelines may contribute to confusion and a reluctance to recommend exercise during pregnancy. Research is needed to clarify discrepant recommendations. [ABSTRACT FROM AUTHOR]