title: Preventing Urinary Incontinence With Supervised Prenatal Pelvic Floor Exercises: A Randomized Controlled Trial.
abstract: OBJECTIVE
  To compare, in an unselected population of nulliparous pregnant women, the postnatal effect of prenatal supervised pelvic floor muscle training with written instructions on postpartum urinary incontinence (UI).
  
  
  METHODS
  In a randomized controlled trial in two parallel groups, 282 women were recruited from five university teaching hospitals in France and randomized during the second trimester of pregnancy. The physiotherapy group received prenatal individually supervised exercises. Both groups received written instructions about how to perform exercises at home. Women were blindly assessed at baseline, end of pregnancy, and 2 and 12 months postpartum. The primary outcome measured was UI severity, assessed with an International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form score (range 0-21; 1-5 is slight UI) at 12 months postpartum; other outcomes were UI prevalence and pelvic floor troubles assessed using self-administered questionnaires. To give a 1-point difference in UI severity score, we needed 91 women in each group (standard deviation 2.4, α=0.05, β=0.20, and bilateral analysis).
  
  
  RESULTS
  Between February 2008 and June 2010, 140 women were randomized in the physiotherapy group and 142 in the control group. No difference was observed between the two groups in UI severity, prevalence, or pelvic floor troubles at baseline, end of pregnancy, and at 2 and 12 months postpartum. At 12 months postpartum, the primary outcome was available for 190 women (67.4%); mean UI severity was 1.9 in the physiotherapy group compared with 2.1 in the control group (P=.38).
  
  
  CONCLUSIONS
  Prenatal supervised pelvic floor training was not superior to written instructions in reducing postnatal UI.
  
  
  BACKGROUND
  ClinicalTrials.gov; www.clinicaltrials.gov, NCT00551551.
  
  
  METHODS
  I.
authors.affiliation: Université de Poitiers, INSERM CIC1402, CHU de Poitiers, Poitiers, France; INSERM U1018, INED, and Université ParisSud-11, CHU Bicêtre APHP, Kremlin-Bicêtre, Université de Montpellier-1, CHU Carémeau, Nîmes, Hôpital intercommunal de Poissy-Saint-Germain-en-Laye, Poissy, Centre Hospitalier d'Arcachon, Arcachon, Université de la Réunion, CHU de Saint-Denis, Saint-Denis-de-la-Réunion, Université ParisSud-11, CHU Antoine-Béclère APHP, Clamart, Montreuil, and Université Versailles-St-Quentin, Research Unit EA 7285, Montigny-le-Bretonneux, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Fritel
authors.forename: Renaud
authors.initials: R
authors.lastname: de Tayrac
authors.forename: Georges
authors.initials: G
authors.lastname: Bader
authors.forename: Denis
authors.initials: D
authors.lastname: Savary
authors.forename: Ameth
authors.initials: A
authors.lastname: Gueye
authors.forename: Xavier
authors.initials: X
authors.lastname: Deffieux
authors.forename: Hervé
authors.initials: H
authors.lastname: Fernandez
authors.forename: Claude
authors.initials: C
authors.lastname: Richet
authors.forename: Joëlle
authors.initials: J
authors.lastname: Guilhot
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fauconnier
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000473:pathology / Q000503:physiopathology; D059952:Pelvic Floor Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D011644:Puerperal Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control