AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain.
Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Acta Obstet Gynecol Scand. 2024 Jun;103(6):1015-1027. doi: 10.1111/aogs.14744. Epub 2023 Dec 23.
The complex process of pregnancy and childbirth significantly influences the well-being of both mother and child. Today all pregnant women without medical contraindications are recommended to start or continue regular aerobic and strength training for at least 150 min per week to prevent pregnancy-related diseases and conditions. Urinary incontinence in pregnancy, episiotomy and third- or fourth-degree perineal tear during labor can greatly impact womens' health, quality of life and ability to be physically active. The aim of this study was to examine the efficacy of pelvic floor muscle training (PFMT) during pregnancy in the prevention of urinary incontinence, episiotomy, and third- or fourth-degree perineal tear.
A systematic review and meta-analysis (CRD42022370600) was performed. Only randomized clinical trials published between 2010 and 2023 were included. The following databases were examined: EBSCO (including Academic Search Premier, Education Resources Information Center, MEDLINE, SPORTDiscus and OpenDissertations databases), Clinicaltrials.gov, Web of Science, Scopus, Cochrane Database of Systematic Reviews and Physiotherapy Evidence Database (PEDro). Three meta-analyses to investigate the effect of PFMT exclusively or implemented as a section within a physical activity program during pregnancy on urinary incontinence, episiotomy, and third- or fourth-degree perineal tear were conducted.
Thirty studies were analyzed (N = 6691). An effective preventive action of PFMT was found for urinary incontinence (z = 3.46; p < 0.0005; relative risk [RR] = 0.72, 95% confidence interval [CI]: 0.59, 0.87, I = 59%) and third- or fourth-degree perineal tear (z = 2.89; p = 0.004; RR = 0.50, 95% CI: 0.31, 0.80, I = 48%) but not for episiotomy (z = 0.80; p = 0.42; RR = 0.95, 95% CI: 0.85, 1.07, I = 75%).
PFMT during pregnancy proves to be an effective preventive intervention for reducing the risk of urinary incontinence and the occurrence of third- or fourth-degree perineal tears. These findings highlight the importance of incorporating PFMT into antenatal care and training programs to improve maternal well-being and overall childbirth outcomes.
妊娠和分娩的复杂过程对母婴的健康都有重大影响。如今，建议所有没有医学禁忌症的孕妇每周至少进行 150 分钟的常规有氧运动和力量训练，以预防与妊娠相关的疾病和状况。妊娠期间的尿失禁、会阴切开术和分娩时的三度或四度会阴撕裂，会极大地影响女性的健康、生活质量和身体活动能力。本研究旨在探讨妊娠期间进行骨盆底肌肉训练（PFMT）对预防尿失禁、会阴切开术和三度或四度会阴撕裂的效果。
进行了系统评价和荟萃分析（CRD42022370600）。仅纳入 2010 年至 2023 年发表的随机临床试验。检查了以下数据库：EBSCO（包括 Academic Search Premier、Education Resources Information Center、MEDLINE、SPORTDiscus 和 OpenDissertations 数据库）、Clinicaltrials.gov、Web of Science、Scopus、Cochrane 系统评价数据库和物理治疗证据数据库（PEDro）。进行了三项荟萃分析，以研究仅进行 PFMT 或在妊娠期间作为身体活动计划的一部分进行 PFMT 对尿失禁、会阴切开术和三度或四度会阴撕裂的影响。
分析了 30 项研究（N=6691）。发现 PFMT 对尿失禁（z=3.46；p<0.0005；相对风险 [RR] =0.72，95%置信区间 [CI]：0.59，0.87，I=59%）和三度或四度会阴撕裂（z=2.89；p=0.004；RR=0.50，95%CI：0.31，0.80，I=48%）有有效的预防作用，但对会阴切开术（z=0.80；p=0.42；RR=0.95，95%CI：0.85，1.07，I=75%）没有作用。
妊娠期间进行 PFMT 被证明是一种有效的预防干预措施，可降低尿失禁风险和三度或四度会阴撕裂的发生风险。这些发现强调了将 PFMT 纳入产前保健和培训计划的重要性，以改善母婴健康和整体分娩结局。
