Do perineal exercises during pregnancy prevent the development of urinary incontinence? A systematic review.
OBJECTIVE
The aim of the current article was to conduct a systematic review of the performance of perineal exercises during pregnancy and their utility in the prevention of urinary incontinence.


METHODS
Randomized controlled studies (RCT) of a low-risk obstetric population (primiparas or nulliparas) who had done perineal exercises only during pregnancy met the inclusion criteria. Articles published between 1966 and 2007 from periodicals indexed in the LILACS, SCIELO, PubMed/MEDLINE, SCIRUS and Cochrane Library databases were selected, using the following keywords: 'urinary incontinence', 'pregnancy', 'pelvic floor' and 'exercise'. The Jadad scale was applied to assess the internal validity of the RCT and two meta-analysis: one of fixed effects and the other of random effects were carried out with data extracted from the RCT, using the Stata 9.2 statistical software and adopting a significance level of 0.05.


RESULTS
Four RCTs with high methodological quality, involving a total of 675 women were included. They indicated that perineal muscle exercise significantly reduced the development of urinary incontinence from 6 weeks to 3 months after delivery (odds ratio = 0.45; confidence interval: 0.3 to 0.66). However, when evaluating this effect during the 34th and 35th gestational week, a meta-analysis showed that the results were not significant (odds ratio = 0.13; confidence interval: 0.00 to 3.77).


CONCLUSIONS
Pelvic floor muscle exercises may be effective at reducing the development of postpartum urinary incontinence, despite clinical heterogeneity among the RCT.
Lemos
Andrea
A
Instituto Materno Infantil Prof. Fernando Figueira, Recife, Pernambuco, Brazil. lemosandrea@bol.com.br
de Souza
Ariani Impieri
AI
Ferreira
Ana Laura Carneiro Gomes
AL
Figueiroa
José Natal
JN
Cabral-Filho
José Eulálio
JE
D005081:Exercise Therapy; D005260:Female; D006801:Humans; D010502:Perineum; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D014549:Urinary Incontinence / Q000517:prevention & control*