Does regular exercise including pelvic floor muscle training prevent urinary and anal incontinence during pregnancy? A randomised controlled trial.

OBJECTIVE

To assess whether pregnant women following a general exercise course, including pelvic floor muscle training (PFMT), were less likely to report urinary and anal incontinence in late pregnancy than a group of women receiving standard care.

DESIGN

A two-armed, two-centred randomised controlled trial.

SETTING

Trondheim University Hospital (St. Olavs Hospital) and Stavanger University Hospital, in Norway.

POPULATION

A total of 855 women were included in this trial.

METHODS

The intervention was a 12-week exercise programme, including PFMT, conducted between 20 and 36 weeks of gestation. One weekly group session was led by physiotherapists, and home exercises were encouraged at least twice a week. Controls received regular antenatal care.

MAIN OUTCOME MEASURES

Self-reported urinary and anal incontinence after the intervention period (at 32-36 weeks of gestation).

RESULTS

Fewer women in the intervention group reported any weekly urinary incontinence (11 versus 19%, P = 0.004). Fewer women in the intervention group reported faecal incontinence (3 versus 5%), but this difference was not statistically significant (P = 0.18).

CONCLUSIONS

The present trial indicates that pregnant women should exercise, and in particular do PFMT, to prevent and treat urinary incontinence in late pregnancy. Thorough instruction is important, and specific pelvic floor muscle exercises should be included in exercise classes for pregnant women. The preventive effect of PFMT on anal incontinence should be explored in future trials.