Physical activity guidance for pregnancy after cancer is sparse and siloed, scoping review finds

BackgroundImprovements in cancer survival have resulted in a growing number of women of reproductive age who plan pregnancy or become pregnant after cancer. Physical activity is widely recommended during pregnancy and across the cancer survivorship continuum; however, there is currently no existing guidance adequately addressing women who fall at the intersection of these contexts. This scoping review was aimed at mapping existing guidance on physical activity during pregnancy and cancer survivorship, and to identify gaps relevant to women planning pregnancy or who become pregnant after cancer treatment.Materials and methodsA scoping review of clinical practice guidelines, position statements and consensus documents addressing physical activity during preconception, pregnancy, postpartum or cancer survivorship was conducted. Sources were identified through database searches. Data were presented according to population (preconception, pregnancy, postpartum, cancer survivorship, pregnancy after cancer) and recommendation domains, including exercise prescription, safety, cancer treatment-related considerations, monitoring and progression, and implementation pathways.ResultsA total of N = [34] sources met the inclusion criteria. Guidance specifically addressing the preconception period was sparse; accordingly, the pregnancy-focused corpus was dominated by recommendations for pregnancy, with more limited reference to preconception and postpartum. Pregnancy guidelines showed high concordance in recommending at least 150 min per week of moderate-intensity physical activity for women without contraindications and provided structured safety guidance. Cancer survivorship guidance consistently endorsed regular physical activity and avoidance of inactivity, often recommending similar activity doses, while more comprehensively addressing treatment-related late effects and implementation considerations. No source provided integrated or population-specific guidance for physical activity in women planning pregnancy or becoming pregnant after cancer. This absence was consistent across all recommendation domains.ConclusionAlthough physical activity guidance is well established for pregnancy and cancer survivorship independently, recommendations remain siloed and do not address the needs of women navigating pregnancy after cancer. Integrated, interdisciplinary guidance is needed to support safe, individualised physical activity participation in this growing population.Systematic review registrationhttps://doi.org/10.17605/OSF.IO/KJVPS.