Abstract
Abbreviations:
CINAHL (Cumulative Index to Nursing and Allied Health Literature), CONSORT (CONsolidated Standards of Reporting Trials), CS (Colin Simonson), DD (David Desseauve), EMBASE (Excerpta Medica database), GRADE (Grading of recommendations Assessments, Development and Evaluation), NvA (Nadine von Aarburg), NVR (Nikolaus Veit-Rubin), OR (Odds ratio), PEDro (Physiotherapy Evidence Database), PFMT (Pelvic floor muscle training), STROBE (Strengthening the Reporting of Observational Studies in Epidemiology), Tra (Transversus abdominis), UI (Urinary incontinence), WHO (World Health Organization)Keywords
Introduction
Organisation mondiale de la Santé | Activité physique [Internet]. WHO. [cited 2018 Sep 6]. Available from: http://www.who.int/dietphysicalactivity/pa/fr/.
Organisation mondiale de la Santé | Recommandations mondiales en matière d’activité physique pour la santé [Internet]. WHO. [cited 2018 Sep 7]. Available from: http://www.who.int/dietphysicalactivity/factsheet_recommendations/fr/.
Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Incontinence Group, editor. Cochrane Database Syst Rev [Internet]. 2017 Dec 22 [cited 2019 Apr 25]; Available from: http://doi.wiley.com/10.1002/14651858.CD007471.pub3.
Methods
Data sources
Eligibility criteria
World Health Organization | WHO recommendations on postnatal care of the mother and newborn [Internet]. WHO; [cited 2020 Apr 1]. Available from: http://www.who.int/maternal_child_adolescent/documents/postnatal-carerecommendations/en/.
Organisation mondiale de la Santé | Activité physique [Internet]. WHO. [cited 2018 Sep 6]. Available from: http://www.who.int/dietphysicalactivity/pa/fr/.
Main outcomes
Data extraction
Assessment of risk of bias
Assessment of the quality of evidence
Physical activity compared with no physical activity for urinary incontinence during pregnancy | ||||||
Population: Pregnant women | ||||||
Setting: Pregnancy | ||||||
Exposition: Physical activity | ||||||
Comparison: No physical activity | ||||||
Outcome | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
Assumed risk | Corresponding risk | |||||
No physical activity | Physical activity | |||||
Urinary incontinence during pregnancy | 535 per 1000 | 525 per 1000 (465 to 599) | RR 0.98 (0.87 to 1.12) | 960 (3) | ⊕⊕⊝⊝ low | – |
Physical activity compared with no physical activity for urinary incontinence during postpartum period | ||||||
Population: Postpartum women | ||||||
Setting: Postpartum period | ||||||
Exposition: Physical activity | ||||||
Comparison: No physical activity | ||||||
Outcome | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
Assumed risk | Corresponding risk | |||||
No physical activity | Physical activity | |||||
Postpartum urinary incontinence | 433 per 1000 | 514 per 1000 (433 to 610) | RR 1.19 (1.00 to 1.41) | 742 (2) | ⊕⊕⊝⊝ low | – |
Statistical analysis
PROSPERO registration number
Results
General characteristics of the studies
- Moher D.
- Liberati A.
- Tetzlaff J.
- Altman D.G.
- The PRISMA Group

Risk of bias of included studies


Synthesis of the results


Discussion
Main findings
Overall completeness and applicability of evidence and comparison with existing literature
Implication for clinical practice and field of knowledge
Organisation mondiale de la Santé | Qu’entend-on par activité physique modérée ou intense? [Internet]. WHO. [cited 2018 Sep 7]. Available from: http://www.who.int/dietphysicalactivity/physical_activity_intensity/fr/.
Limitations of the review
Conclusion
Author contributions
Funding
Declaration of Competing Interest
Acknowledgements
Appendix A. Supplementary data
- Supplementary data 1
- Supplementary data 2
- Supplementary data 3
- Supplementary data 4
- Supplementary data 5
References
Milsom I, Altman D, Cartwright R, et al. Epidemiology of urinary incontinence and other lower urinary tract symptoms [LUTS], pelvic organ prolapse [POP] and anal incontinence [AI]. In: Abrams P, Wagg A, Wein A, editors. Incontinence. Tokyo: 6th international consultation on incontinence; 2017.
- The burden of lower urinary tract symptoms: evaluating the effect of LUTS on health-related quality of life, anxiety and depression: EpiLUTS.BJU Int. 2009; 103: 4-11
- The quality of life in women with urinary incontinence as measured by the sickness impact profile.J Am Geriatr Soc. 1991; 39: 378-382
- Levator ani muscle stretch induced by simulated vaginal birth.Obstet Gynecol. 2004; 103: 31-40
- Place de la césarienne dans la protection périnéale obstétricale. RPC Prévention et protection périnéale en obstétrique CNGOF.Gynécologie Obstétrique Fertil Sénologie. 2018; 46: 968-985
- Editorial comment on: Boyle, et al. Pelvic floor muscle training for prevention and treatment of urinary and fecal incontinence in antenatal and postnatal women: a short version Cochrane review. Neurourol Urodyn 2014;33:269–276: Editorial Comment.Neurourol Urodyn. 2014; 33 (277-277)
Organisation mondiale de la Santé | Activité physique [Internet]. WHO. [cited 2018 Sep 6]. Available from: http://www.who.int/dietphysicalactivity/pa/fr/.
Organisation mondiale de la Santé | Recommandations mondiales en matière d’activité physique pour la santé [Internet]. WHO. [cited 2018 Sep 7]. Available from: http://www.who.int/dietphysicalactivity/factsheet_recommendations/fr/.
- Physical activity and the pelvic floor.Am J Obstet Gynecol. 2016; 214: 164-171
- Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study.BJOG Int J Obstet Gynaecol. 2003; 110: 247-254
Zhu L, Lang J, Wang H, Han S, Huang J. The prevalence of and potential risk factors for female urinary incontinence in Beijing, China: Menopause. 2008 May;15(3):566–9.
- Physical activity and incident urinary incontinence in middle-aged women.J Urol. 2008; 179: 1012-1017
- Factors associated with persistent urinary incontinence.Am J Obstet Gynecol. 2013; 209: 145.e1-145.e6
- Prenatal exercise (including but not limited to pelvic floor muscle training) and urinary incontinence during and following pregnancy: a systematic review and meta-analysis.Br J Sports Med. 2018; 52: 1397-1404
- Physical activity and exercise during pregnancy.Eur J Physiother. 2014; 16: 2-9
- Benefits of aerobic or resistance training during pregnancy on maternal health and perinatal outcomes: a systematic review.Early Hum Dev. 2016; 94: 43-48
Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Incontinence Group, editor. Cochrane Database Syst Rev [Internet]. 2017 Dec 22 [cited 2019 Apr 25]; Available from: http://doi.wiley.com/10.1002/14651858.CD007471.pub3.
ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obtetrics Gynecol. 2015;126(6):e135–42.
- Higgins J.P. Green S. Cochrane Handbook for Systematic Reviews of Interventions. John Wiley & Sons, Chichester (UK)2008.24.
World Health Organization | WHO recommendations on postnatal care of the mother and newborn [Internet]. WHO; [cited 2020 Apr 1]. Available from: http://www.who.int/maternal_child_adolescent/documents/postnatal-carerecommendations/en/.
- Female urinary incontinence, from pregnancy to menopause: a review of epidemiological and pathophysiological findings.Acta Obstet Gynecol Scand. 2012; 91: 901-910
- The EDEN Mother-Child Cohort Study Group. Trends in urinary incontinence in women between 4 and 24 months postpartum in the EDEN cohort..BJOG Int J Obstet Gynaecol. 2016; 123: 1222-1228
- An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction.Int Urogynecology J. 2010; 21: 5-26
- Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration.Int J Surg. 2014; 12: 1500-1524
Moher D, Hopewell S, Schulz KF, et al. CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010 Mar 23;340(mar23 1):c869–c869.
GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ. 2004 Jun 19;328(7454):1490.
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.PLoS Med. 2009; 6e1000097https://doi.org/10.1371/journal.pmed1000097
- The effect of tRa training and Pilates in women with stress urinary incontinence.Biomed India. 2018; 38: 404-407
- Exercise behaviors and health conditions of runners after childbirth.Sports Health. 2017; 9: 45-51
- The prevalence of urinary incontinence in pregnancy among a multi-ethnic population resident in Norway.BJOG Int J Obstet Gynaecol. 2012; 119: 1354-1360
- Regular exercisers have stronger pelvic floor muscles than nonregular exercisers at midpregnancy.Am J Obstet Gynecol. 2018; 218: 427.e1-427.e5
- Prevalence and risk factors for peri- and postpartum urinary incontinence in primiparous women in China: a prospective longitudinal study.Int Urogynecology J. 2012; 23: 563-572
- Influence of physical activity on urinary leakage in primiparous women.Scand J Med Sci Sports. 2005; 15: 87-94
- Do elite athletes experience low back, pelvic girdle and pelvic floor complaints during and after pregnancy?.Scand J Med Sci Sports. 2007; 17: 480-487
- Do pregnant women exercise their pelvic floor muscles?.Int Urogynecol J Pelvic Floor Dysfunct. 2007; 18: 733-736
- Exercise interventions for weight management during pregnancy and up to 1 year postpartum among normal weight, overweight and obese women: a systematic review and meta-analysis.Br J Sports Med. 2015; 49: 1336-1342
- Urinary incontinence and weight changes during pregnancy and post partum: a pending challenge.Midwifery. 2013; 29: e123-e129
- Urinary incontinence and weight change during pregnancy and postpartum: a cohort study.Am J Epidemiol. 2010; 172: 1034-1044
Organisation mondiale de la Santé | Qu’entend-on par activité physique modérée ou intense? [Internet]. WHO. [cited 2018 Sep 7]. Available from: http://www.who.int/dietphysicalactivity/physical_activity_intensity/fr/.
- Preventing urinary incontinence during pregnancy and postpartum: a review.Int Urogynecol J. 2013; 24: 889-899
Article info
Publication history
Footnotes
☆This article is based on the results of a Master Thesis conducted within the joint Master of Science (MSc) in Health Sciences of HES-SO (University of Applied Sciences and Arts Western Switzerland) and University of Lausanne (UNIL), major in physiotherapy, at HES-SO Master.
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