Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind randomized controlled trial.
OBJECTIVE
Urinary incontinence is a chronic health complaint that severely reduces quality of life. Pregnancy and vaginal delivery are main risk factors in the development of urinary incontinence. The aim of this study was to assess whether intensive pelvic floor muscle training during pregnancy could prevent urinary incontinence.


METHODS
We conducted a single-blind randomized controlled trial at Trondheim University Hospital and three outpatient physiotherapy clinics in a primary care setting. Three hundred one healthy nulliparous women were randomly allocated to a training (n = 148) or a control group (n = 153). The training group attended a 12-week intensive pelvic floor muscle training program during pregnancy, supervised by physiotherapists. The control group received the customary information. The primary outcome measure was self-reported symptoms of urinary incontinence. The secondary outcome measure was pelvic floor muscle strength.


RESULTS
At follow-up, significantly fewer women in the training group reported urinary incontinence: 48 of 148 (32%) versus 74 of 153 (48%) at 36 weeks' pregnancy (P =.007) and 29 of 148 (20%) versus 49 of 153 (32%) 3 months after delivery (P =.018). According to numbers needed to treat, intensive pelvic floor muscle training during pregnancy prevented urinary incontinence in about one in six women during pregnancy and one in eight women after delivery. Pelvic floor muscle strength was significantly higher in the training group at 36 weeks' pregnancy (P =.008) and 3 months after delivery (P =.048).


CONCLUSIONS
Intensive pelvic floor muscle training during pregnancy prevents urinary incontinence during pregnancy and after delivery. Pelvic floor muscle strength improved significantly after intensive pelvic floor muscle training.
Mørkved
Siv
S
Department of Community Medicine and General Practice, Norwegian University of Science and Technology, Trondheim, Norway. siv.morkved@medisin.ntnu.no
Bø
Kari
K
Schei
Berit
B
Salvesen
Kjell Asmund
KA
D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D009119:Muscle Contraction / Q000502:physiology*; D009130:Muscle, Smooth / Q000502:physiology; D016017:Odds Ratio; D017773:Pelvic Floor; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D011322:Primary Prevention; D011336:Probability; D012016:Reference Values; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000517:prevention & control*