Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
BJOG. 2012 Sep;119(10):1270-80. doi: 10.1111/j.1471-0528.2012.03426.x. Epub 2012 Jul 17.
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.
A two-armed, two-centred randomised controlled trial.
Trondheim University Hospital (St. Olavs Hospital) and Stavanger University Hospital, in Norway.
A total of 855 women were included in this trial.
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.
Self-reported urinary and anal incontinence after the intervention period (at 32-36 weeks of gestation).
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).
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.
评估与接受标准护理的女性相比，参加包括盆底肌训练（PFMT）在内的常规运动课程的孕妇在妊娠晚期报告尿失禁和肛门失禁的可能性是否更小。
双臂、双中心随机对照试验。
挪威特隆赫姆大学医院（圣奥拉夫医院）和斯塔万格大学医院。
共有 855 名女性参与了这项试验。
干预措施是在妊娠 20 至 36 周期间进行为期 12 周的运动方案，包括 PFMT。每周一次的小组课程由物理治疗师授课，并鼓励在家中每周至少进行两次运动。对照组接受常规产前保健。
干预后（妊娠 32-36 周时）的自我报告尿失禁和肛门失禁情况。
干预组每周报告尿失禁的女性人数较少（11%对 19%，P=0.004）。干预组报告粪便失禁的女性人数较少（3%对 5%），但差异无统计学意义（P=0.18）。
本试验表明，孕妇应运动，特别是进行 PFMT，以预防和治疗妊娠晚期的尿失禁。彻底的指导很重要，应在孕妇运动课程中纳入特定的盆底肌肉锻炼。未来的试验应探讨 PFMT 对肛门失禁的预防作用。
