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Abstract
BackgroundAntenatal preparation programmes are recommended worldwide to promote a healthy pregnancy and greater autonomy during labor and delivery, prevent physical discomfort and high levels of anxiety. The objective of this study was to evaluate effectiveness and safety of a birth preparation programme to minimize lumbopelvic pain, urinary incontinence, anxiety, and increase physical activity during pregnancy as well as to compare its effects on perinatal outcomes comparing two groups of nulliparous women.MethodsA randomized controlled trial was conducted with 197 low risk nulliparous women aged 16 to 40 years, with gestational age ≥ 18 weeks. Participants were randomly allocated to participate in a birth preparation programme (BPP; n=97) or a control group (CG; n=100). The intervention was performed on the days of prenatal visits, and consisted of physical exercises, educational activities and instructions on exercises to be performed at home. The control group followed a routine of prenatal care. Primary outcomes were urinary incontinence, lumbopelvic pain, physical activity, and anxiety. Secondary outcomes were perinatal variables.ResultsThe risk of urinary incontinence in BPP participants was significantly lower at 30 weeks of pregnancy (BPP 42.7%, CG 62.2%; relative risk [RR] 0.69; 95% confidence interval [CI] 0.51-0.93) and at 36 weeks of pregnancy (BPP 41.2%, CG 68.4%; RR 0.60; 95%CI 0.45-0.81). Participation in the BPP encouraged women to exercise during pregnancy (p=0.009). No difference was found between the groups regarding to anxiety level, lumbopelvic pain, type or duration of delivery and weight or vitality of the newborn infant.ConclusionsThe BPP was effective in controlling urinary incontinence and to encourage the women to exercise during pregnancy with no adverse effects to pregnant women or the fetuses.Trial registrationClinicaltrials.gov, (NCT01155804)
Highlights
Antenatal preparation programmes are recommended worldwide to promote a healthy pregnancy and greater autonomy during labor and delivery, prevent physical discomfort and high levels of anxiety
Investigations have been conducted to evaluate whether exercise during pregnancy is able to reduce discomfort resulting from lumbopelvic pain and decrease the occurrence of urinary incontinence
Primary outcomes were: lumbopelvic pain, urinary incontinence (UI), anxiety, and physical activity performed at home
Summary
Antenatal preparation programmes are recommended worldwide to promote a healthy pregnancy and greater autonomy during labor and delivery, prevent physical discomfort and high levels of anxiety. The main aims of antenatal preparation programmes are to promote healthy practices, minimize excessive anxiety and prevent or minimize the discomforts of pregnancy and labor. Such programmes may include educational activities, physical exercise and psychoprophylactic. Pennick and Young [9] in a systematic review showed evidence that the practice of specific exercises was able to alleviate lumbopelvic pain during pregnancy It is still under debate whether pelvic floor muscle exercises during pregnancy could protect against urinary incontinence both during pregnancy and in the postpartum period [10,11,12]
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