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Do perineal exercises during pregnancy prevent the development of urinary incontinence? A systematic review
Author(s) -
Lemos Andrea,
de Souza Ariani Impieri,
Ferreira Ana Laura Carneiro Gomes,
Figueiroa José Natal,
CabralFilho José Eulálio
Publication year - 2008
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2008.02145.x
Subject(s) - medicine , urinary incontinence , randomized controlled trial , jadad scale , odds ratio , cochrane library , confidence interval , pelvic floor , pregnancy , obstetrics , meta analysis , medline , gynecology , urology , surgery , biology , political science , law , genetics
Objectives: The aim of the current article was to conduct a systematic review of the performance of perineal exercises during pregnancy and their utility in the prevention of urinary incontinence. Methods: Randomized controlled studies (RCT) of a low‐risk obstetric population (primiparas or nulliparas) who had done perineal exercises only during pregnancy met the inclusion criteria. Articles published between 1966 and 2007 from periodicals indexed in the LILACS, SCIELO, PubMed/MEDLINE, SCIRUS and Cochrane Library databases were selected, using the following keywords: ‘urinary incontinence’, ‘pregnancy’, ‘pelvic floor’ and ‘exercise’. The Jadad scale was applied to assess the internal validity of the RCT and two meta‐analysis: one of fixed effects and the other of random effects were carried out with data extracted from the RCT, using the Stata 9.2 statistical software and adopting a significance level of 0.05. Results: Four RCTs with high methodological quality, involving a total of 675 women were included. They indicated that perineal muscle exercise significantly reduced the development of urinary incontinence from 6 weeks to 3 months after delivery (odds ratio = 0.45; confidence interval: 0.3 to 0.66). However, when evaluating this effect during the 34th and 35th gestational week, a meta‐analysis showed that the results were not significant (odds ratio = 0.13; confidence interval: 0.00 to 3.77). Conclusion: Pelvic floor muscle exercises may be effective at reducing the development of postpartum urinary incontinence, despite clinical heterogeneity among the RCT.