{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:32:38Z","timestamp":1788881558668,"version":"build-2803163510"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The main objective of this review is to determine whether the physical activity (PA) recommendations during pregnancy issued by public health and sports medicine organizations published since 2020 in different countries around the world converge or differ and what are the emerging trends in these guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The review was conducted as per the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched scientific databases (PubMed, ScienceDirect, Web of Science, Academic Search Complete, and SPORTDiscus with Full Text via EBSCO) and the Internet to identify papers regarding official recommendations on PA during pregnancy published by public health and sports medicine organizations. We analyzed 10 eligible guidelines, published from 2020 in English from eight countries and two international organizations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis of the guidelines revealed that all of them advocate for moderate-intensity PA during pregnancy. Seven documents recommended also vigorous or high-intensity activities. Some guidelines recommend it only after consultation with a healthcare provider, particularly for participants with specific health conditions. The analysis of the guidelines shows a convergence on the frequency and duration of PA, suggesting at least 150\u202fmin per week.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a general convergence around the safety and benefits of moderate-intensity PA during pregnancy. There is a divergence in recommendations regarding higher-intensity exercise and altitude training, with limited specific guidance for these activities. However, we have seen much greater openness in this area over recent years. Our work highlights a knowledge gap regarding the safety and efficacy of more intense exercise regimens for pregnant women, emphasizing the need for further research to develop evidence-based guidelines and to address new trends in pregnant population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p>The study protocol was registered on Open Science Framework (registration number: 10.17605\/OSF.IO\/3QFR9).<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1540355","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T05:29:45Z","timestamp":1745818185000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Contradictions and convergences in recommendations on physical activity in pregnancy in different countries after the publication of the WHO guidelines in 2020\u2014a scoping review"],"prefix":"10.3389","volume":"13","author":[{"given":"Aneta","family":"Worska","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janusz","family":"Maciaszek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Ci\u0105\u017cy\u0144ska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Szumilewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1097\/GRF.0000000000000201","article-title":"Maternal responses to aerobic exercise in pregnancy","volume":"59","author":"Davenport","year":"2016","journal-title":"Clin Obstet Gynecol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1177\/17455057221142357","article-title":"Longitudinal association of physical activity during pregnancy with maternal and infant outcomes: findings from the Australian longitudinal study of women\u2019s health","volume":"18","author":"Beetham","year":"2022","journal-title":"Women S Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1186\/s12884-021-03627-6","article-title":"Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes: an epidemiological study","volume":"21","author":"Meander","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1123\/jpah.2021-0477","article-title":"Effects of regular exercise during pregnancy on early childhood neurodevelopment: the physical activity for mothers enrolled in longitudinal analysis randomized controlled trial","volume":"19","author":"de Le\u00e3o","year":"2022","journal-title":"J Phys Activity Health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3389\/fpubh.2022.697386","article-title":"Uncovering barriers to prenatal physical activity and exercise among south African pregnant women: a cross-sectional, mixed-method analysis","volume":"10","author":"Okafor","year":"2022","journal-title":"Front Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"8064","DOI":"10.3390\/ijerph19138064","article-title":"Physical activity during pregnancy: comparisons between objective measures and self-reports in relation to blood glucose levels","volume":"19","author":"Chen","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1840","DOI":"10.3390\/ijerph16101840","article-title":"Effectiveness of physical activity interventions on pregnancy-related outcomes among pregnant women: a systematic review","volume":"16","author":"Chan","year":"2019","journal-title":"Int J Environ Res Public Health"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.jphys.2017.11.012","article-title":"Attitudes, barriers and enablers to physical activity in pregnant women: a systematic review","volume":"64","author":"Harrison","year":"2018","journal-title":"J Physiother"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1232625","DOI":"10.3389\/fpubh.2023.1232625","article-title":"A socio-ecological model of factors influencing physical activity in pregnant women: a systematic review","volume":"11","author":"Sun","year":"2023","journal-title":"Front Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e000963","DOI":"10.1136\/bmjgh-2018-000963","article-title":"Complex health interventions in complex systems: improving the process and methods for evidence-informed health decisions","volume":"4","author":"Norris","year":"2019","journal-title":"BMJ Glob Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"629","DOI":"10.34172\/ijhpm.2020.193","article-title":"Advancing the who-integrate framework as a tool for evidence-informed, deliberative decision-making processes: exploring the views of developers and users of who guidelines","volume":"11","author":"Stratil","year":"2020","journal-title":"Int J Health Policy Manag"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.smhs.2021.05.001","article-title":"2020 WHO guidelines on physical activity and sedentary behavior","volume":"3","author":"Okely","year":"2021","journal-title":"Sports Med Health Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1146\/annurev-publhealth-040617-014746","article-title":"Building capacity for evidence-based public health: reconciling the pulls of practice and the push of research","volume":"39","author":"Brownson","year":"2024","journal-title":"Annu Rev Public Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"609","DOI":"10.3390\/healthcare9050609","article-title":"Physical activity advice and counselling by healthcare providers: a scoping review","volume":"9","author":"Okafor","year":"2021","journal-title":"Healthcare"},{"key":"ref15","volume-title":"Europe active standards EQF level 5- pregnancy and postnatal exercise specialist","author":"Santos-Rocha","year":"2016"},{"key":"ref16","volume-title":"Europe active occupational standards summary document exercise in pregnancy and postpartum lifelong learning standard* (EQF level 4) exercise in pregnancy and postpartum lifelong learning standard* (EQF level 4)","author":"Szumilewicz","year":"2022"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"6","DOI":"10.5937\/mp74-41113","article-title":"Physical activity during pregnancy: benefits and global recommendations","volume":"74","author":"Rov\u010danin","year":"2023","journal-title":"Medicinski Podmladak"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1186\/s13102-022-00524-z","article-title":"Physical activity during pregnancy: a systematic review for the assessment of current evidence with future recommendations","volume":"14","author":"Cilar","year":"2022","journal-title":"BMC Sports Sci Med Rehabil"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3","DOI":"10.2174\/157340481101150914200838","article-title":"Summary of guidelines for exercise in pregnancy\u2013are they comprehensive enough for designing the contents of a prenatal exercise program?","volume":"11","author":"Szumilewicz","year":"2015","journal-title":"Curr Women S Health Rev"},{"key":"ref20","first-page":"157","volume-title":"Evidence-based and practice-oriented guidelines for exercising during pregnancy","author":"Szumilewicz","year":"2018"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"S5","DOI":"10.1249\/mss.0b013e3182399c0e","article-title":"Assessing physical activity using wearable monitors","volume":"44","author":"Butte","year":"2011","journal-title":"Med Sci Sports Exerc"},{"key":"ref22","year":"2018"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-SCR): checklist and explanation","volume":"169","author":"Tricco","year":"2018","journal-title":"Ann Intern Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e178","DOI":"10.1097\/AOG.0000000000003772","article-title":"Physical activity and exercise during pregnancy and the postpartum period","volume":"135","author":"Authors","year":"2020","journal-title":"Obstet Gynecol"},{"key":"ref25","volume-title":"Austrian physical activity recommendations\u2014Key messages","year":"2020"},{"key":"ref26","year":"2020"},{"key":"ref27","volume-title":"Evidence-based physical activity guidelines for pregnant women: Report for the Australian government","year":"2020"},{"key":"ref28","year":"2020"},{"key":"ref29","volume-title":"Guidelines for physical activity during pregnancy","year":"2021"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"160","DOI":"10.36660\/abc.20210408","article-title":"Posicionamento sobre Exerc\u00edcios F\u00edsicos na Gesta\u00e7\u00e3o e no P\u00f3s-Parto \u2013 2021","volume":"117","author":"Campos","year":"2021","journal-title":"Arq Bras Cardiol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.ejogrb.2023.03.038","article-title":"High-intensity exercise during pregnancy \u2013 a position paper by the European board and College of Obstetrics and Gynaecology (EBCOG)","volume":"285","author":"Harmsworth","year":"2023","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.5603\/GP.a2023.0080","article-title":"Polish Society of Gynecologists and Obstetricians (PTGiP) and polish Society of Sports Medicine (PTMS) recommendations on physical activity during pregnancy and the postpartum period","author":"Kwiatkowska","year":"2023","journal-title":"Ginekol Pol"},{"key":"ref33","volume-title":"New Zealand College of Obstetricians. Gynaecologist (RANZCOG) exercise in pregnancy","year":"2023"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1136\/bjsports-2022-105777","article-title":"Public health guidelines for physical activity during pregnancy from around the world: a scoping review","volume":"57","author":"Hayman","year":"2023","journal-title":"Br J Sports Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1186\/s12884-015-0756-0","article-title":"Compliance with national recommendations for exercise during early pregnancy in a Danish cohort","volume":"15","author":"Broberg","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1089\/whr.2021.0132","article-title":"Exercise during pregnancy: what do OB\/GYNs believe and practice? A descriptive analysis","volume":"3","author":"Nelson","year":"2022","journal-title":"Women S Health Rep"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1177\/15598276211026591","article-title":"Exercise behaviors and beliefs among pregnant women in rural communities","volume":"17","author":"Stickford","year":"2021","journal-title":"Am J Lifestyle Med"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1186\/s12884-020-03439-0","article-title":"Physical activity and exercise during pregnancy in Africa: a review of the literature","volume":"20","author":"Okafor","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1177\/15598276221108669","article-title":"Understanding barriers and facilitators to physical activity engagement to inform a precision prescription approach during pregnancy","volume":"17","author":"Sparks","year":"2022","journal-title":"Am J Lifestyle Med"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1136\/hrt.2006.093674","article-title":"Exercise really is good for you","volume":"92","author":"Wannamethee","year":"2006","journal-title":"Heart"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1146\/annurev-publhealth-031210-101151","article-title":"Physical activity for health: what kind? How much? How intense? On top of what?","volume":"32","author":"Powell","year":"2011","journal-title":"Annu Rev Public Health"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1093\/ije\/dys038","article-title":"Vigorous intensity physical activity is related to the metabolic syndrome independent of the physical activity dose","volume":"41","author":"Janssen","year":"2012","journal-title":"Int J Epidemiol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1177\/1941738115599358","article-title":"Exercise in pregnancy","volume":"7","author":"Hinman","year":"2015","journal-title":"Sports Health a Multidiscip Approach"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"15454","DOI":"10.14814\/phy2.15454","article-title":"Glycemic response to acute high-intensity interval versus moderate-intensity continuous exercise during pregnancy","volume":"10","author":"Wowdzia","year":"2022","journal-title":"Phys Rep"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1819","DOI":"10.1007\/s40279-023-01858-5","article-title":"Maternal and fetal cardiovascular responses to acute high-intensity interval and moderate-intensity continuous training exercise during pregnancy: a randomized crossover trial","volume":"53","author":"Wowdzia","year":"2023","journal-title":"Sports Med"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"5279","DOI":"10.3390\/nu14245279","article-title":"Effects of 8-week online, supervised high-intensity interval training on the parameters related to the anaerobic threshold, body weight, and body composition during pregnancy: a randomized controlled trial","volume":"14","author":"Yu","year":"2022","journal-title":"Nutrients"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1186\/s13102-022-00610-2","article-title":"Can we hit prenatal depression and anxiety through HIIT? The effectiveness of online high intensity interval training in pregnant women during the COVID-19 pandemic: a randomized controlled trial","volume":"14","author":"Wilczy\u0144ska","year":"2022","journal-title":"BMC Sports Sci Med Rehabil"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"11","DOI":"10.3389\/fpubh.2023.1307998","article-title":"Stress is not so bad\u2014cortisol level and psychological functioning after 8-week HIIT program during pregnancy: a randomized controlled trial","volume":"11","author":"Wilczy\u0144ska","year":"2024","journal-title":"Front Public Health"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"Article-1","DOI":"10.29359\/bjhpa.14.1.01","article-title":"How to HIIT while pregnant? The protocol characteristics and effects of high intensity interval training implemented during pregnancy \u2013 a systematic review","volume":"14","author":"Szumilewicz","year":"2021","journal-title":"Baltic J Health Phys Act"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.wem.2016.02.010","article-title":"Outdoor activity and high altitude exposure during pregnancy: a survey of 459 pregnancies","volume":"27","author":"Keyes","year":"2016","journal-title":"Wilderness Environ Med"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"7","DOI":"10.2174\/1874091x01509010007","article-title":"Evaluation of hemoglobin concentration in pregnancy and correlation with different altitude: a study from Balochistan plateau of Pakistan","volume":"9","author":"Rasool","year":"2015","journal-title":"Open Biochem J"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"9272","DOI":"10.3390\/ijerph18179272","article-title":"Integrative review of exercise at altitude during pregnancy","volume":"18","author":"McManis","year":"2021","journal-title":"Int J Environ Res Public Health"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1540355\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T05:29:48Z","timestamp":1745818188000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1540355\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":52,"alternative-id":["10.3389\/fpubh.2025.1540355"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1540355","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]},"article-number":"1540355"}}