Antenatal pelvic floor muscle training and urinary incontinence: a randomized controlled 7-year follow-up study

Int Urogynecol J. 2022 Jun;33(6):1557-1565. doi: 10.1007/s00192-021-05028-x. Epub 2021 Dec 22.

Abstract

Introduction and hypothesis: Urinary incontinence is common postpartum. Our aims were to assess whether antenatal exercise including pelvic floor muscle training (PFMT) has long-term effects on urinary incontinence (UI) and to explore factors associated with UI 7 years postpartum.

Methods: A follow-up of a two-centre randomized controlled trial performed at St. Olavs Hospital and Stavanger University Hospital, Norway. In the original trial women were randomized to a 12-week structured exercise protocol including PFMT or standard antenatal care during pregnancy. Link to an electronic questionnaire was sent by postal mail 7 years postpartum. Prevalence of UI was assessed with Sandvik severity index and compared between groups. Factors associated with UI were studied using multivariable logistic regression analysis.

Results: The response rate was 35% (298/855). UI was reported by 78 (51%) in the intervention group and 63 (57%) in the control group (p = 0.539). In the multivariable logistic regression analyses, women with UI at inclusion had a five-fold increase in odds of UI at 7 years (OR 5.4, 95% CI 2.6, 11.5). Engaging in regular exercise was not significantly associated with UI at 7 years; however, UI was associated with lower exercise intensity (OR 2.4, 95% CI 1.2, 4.6).

Conclusions: We found no group differences of antenatal exercise including PFMT on UI after 7 years among the responders. UI in pregnancy increased the risk of long-term UI. Regular exercise was not associated with UI at 7 years; however, women with UI were more than twice as likely to exercise at lower intensity than continent women.

Keywords: Long-term effect; Pelvic floor muscle training; Pregnancy; Prevention; Urinary incontinence; Women.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Exercise Therapy / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Pelvic Floor*
  • Pregnancy
  • Prenatal Care
  • Treatment Outcome
  • Urinary Incontinence* / epidemiology
  • Urinary Incontinence* / therapy