In a Cochrane review, pelvic muscle training program before giving birth reduced self-reported urinary incontinence in late pregnancy and in under 6 months follow-up after giving birth. For patients without incontinence when randomized, at 0-3 months (late pregnancy), 14% of participants in training programs vs 38% in control group experienced urinary incontinence (leakage) «Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1. At 3-6 months (mid postnatal period), respective numbers were 14% and 25%. Urinary incontinence prevalence decreases in longer follow-up, and the evidence for longer follow-ups is uncertain.
The level of evidence was downgraded due to high risk of bias.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias |
|---|---|---|---|---|---|
| RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis; ICIQ‐SF=urinary incontinence specific quality of life | |||||
| «Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 | SR/MA | Pregnant/postnatal women with or without urinary incontinence | Any pelvic muscle training program during pregnancy vs no intervention/usual care/placebo | Self-reported urinary incontinence, ICIQ-SF | High |
| Reference | Comments |
|---|---|
| «Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 | Excluded trials with intervention combining training programs with drug treatment or with another stand-alone therapy. ICIQ-SF=urinary incontinence specific quality of life. Risk of bias was high in all trials due to no blinding and in some trials, also due to incomplete outcome data. |
Results
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations. I=intervention; C=comparison; CI=confidence interval |
|||||
| «Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 | 6 studies (296/328) | - | 44 (15%) | 138 (42%) | 0.38 (0.20-0.72) |
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations. I=intervention; C=comparison; CI=confidence interval |
|||||
| «Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 | 5 studies (207/232) | 0-3 months | 29 (14%) | 88 (38%) | 0.38 (0.17-0.83) |
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations. There was also some imprecision (confidence interval could include clinically not meaningful benefit) but not warranting another downgrade in the evidence certainty. I=intervention; C=comparison; CI=confidence interval |
|||||
| «Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 | 5 studies (335/338) | 3-6 months | 59 (14%) | 85 (25%) | 0.71 (0.54-0.95) |
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Mean (sd) I | Mean (sd) C | Mean difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: low The quality of evidence is downgraded due to study limitations and imprecision. I=intervention; C=comparison; CI=confidence interval |
|||||
| «Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 | 1 study (20/21) | 6-12 months | 1.2 (2.5) | 4.7 (5.6) | -3.50 (-6.13 to -0.87) |