OBJECTIVE: A prospective randomized controlled trial was designed to assess the benefits and possible risks of aerobic exercise during pregnancy, using a fitness regimen based on the 2002 ACOG guidelines for exercise during pregnancy. METHODS: Inactive women were randomized at 12 to 14 weeks gestation to a group which remained sedentary, or to a group which performed moderate aerobic exercise 45 to 60 minutes, 4 days per week, through 36 weeks gestation. 31 subjects in each group completed the study. RESULTS: Compared to women who remained sedentary, active women improved aerobic fitness (p < 0.05) and muscular strength (p < 0.01), delivered comparable size infants with significantly fewer Caesarean deliveries (p < 0.01), and recovered faster postpartum (p < 0.05), at least related to the lower incidence of C. section. Active women developed no gestational hypertension (p = 0.16 compared to controls) and reported no injuries related to the exercise regimen. In the active group there was one premature birth at 33 weeks by a woman with a past history of premature delivery of twins at 34 weeks. There were no differences between groups in incidence of gestational diabetes, musculoskeletal pains during pregnancy, flexibility on sit-and- reach test, mean length of pregnancy, neonatal Apgar scores, placenta weights, overall length of labor, weight gain during pregnancy, or weight retention postpartum. CONCLUSION: Previously sedentary women who began exercising at 12 to 14 weeks improved fitness and delivery outcomes.

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