Knowledge and practice of physical exercise during pregnancy: protocol for a multicenter cross-sectional study

BACKGROUND: Exercising during pregnancy is widely recommended in clinical guidelines due to its numerous benefits for maternal and fetal health. However, adherence remains low worldwide, particularly among pregnant women, even though pregnancy is considered a favorable period for adopting healthy habits. This cross-sectional, multicenter study aims to assess knowledge and practice of physical exercise during pregnancy and compare findings according to gestational risk, with a focus in preeclampsia. METHODS: Multicenter cross-sectional study that will recruit 1,812 postpartum women from ten Brazilian maternity hospitals to assess knowledge, practice, and prenatal guidance on physical exercise, comparing low-risk and high-risk pregnancies. Data collection will include validated questionnaires, such as the Pregnancy Physical Activity Questionnaire, and the review of medical charts for maternal and perinatal outcomes. Statistical analyses will identify the overall frequency of physical exercise, frequency of preeclampsia and other adverse maternal outcomes and further compare cases of low and high-risk pregnancies. Factors associated with exercise adherence will also be considered. In addition, details regarding the initial gestational age of the exercise practice, the modality, and the guidance received will be reported. DISCUSSION: This study addresses important gaps in counseling and exercise adoption during pregnancy. Findings will shed light on barriers and facilitators to physical exercise, the quality of professional guidance, and the impact of prenatal counseling on women's behaviors. This evidence will support tailored, individualized strategies to promote safe exercise, aiming to improve maternal health and reduce adverse outcomes, including those related to preeclampsia, thereby fostering more confident and proactive antenatal care.