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Evaluation of a birth preparation program on lumbopelvic pain, urinary incontinence, anxiety and exercise: a randomized controlled trial.

Miquelutti MA, Cecatti JG, Makuch MY - BMC Pregnancy Childbirth (2013)

Bottom Line: 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 iparous women.Secondary outcomes were perinatal variables.The 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).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Caixa Postal 618113083-970, Campinas, São Paulo, Brazil.

ABSTRACT

Background: 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 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 iparous women.

Methods: A randomized controlled trial was conducted with 197 low risk iparous 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.

Results: The 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.

Conclusions: The 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 registration: Clinicaltrials.gov, (NCT01155804).

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Related in: MedlinePlus

Comparison of energy expenditure per week among groups.
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Figure 2: Comparison of energy expenditure per week among groups.

Mentions: Anxiety level was similar in both groups throughout pregnancy, being low/moderate (scores between 20 and 49) in the majority of women at the three evaluations. The Table 5 shows the percentages of the women who presented high and very high anxiety levels. Data related to the physical activities evaluated using the PPAQ, showed a difference between the groups regarding the energy expenditure of physical exercise, with increased (initial to final evaluation) in the BPP (1.4 MET-hrs/wk) and decreased in the CG (-0.3 MET-hrs/wk), with a significant difference between groups (p=0.009; Anova test). There was no difference between the groups regarding the other types of physical activity (Figure 2). The median increase in maternal weight between baseline and the final evaluation was similar in both groups, 8,5 kg (interquartile range–Q1: 6,2 kg; Q3: 11,8 kg) in the BPP group and 7,9 kg (Q1: 6,4 kg; Q3: 10,6 kg) in the control group (p=0.81, Mann–Whitney test; data not shown). Analysis of the participants’ adherence with the exercises to be performed at home was unfeasible because the women either failed to complete the exercise diary or failed to bring it with them on their return to the clinic. No adverse events associated with the exercise were reported by the participants. Regarding the analysis of the perinatal data, no difference was found between the groups, except for length of delivery (Table 6).


Evaluation of a birth preparation program on lumbopelvic pain, urinary incontinence, anxiety and exercise: a randomized controlled trial.

Miquelutti MA, Cecatti JG, Makuch MY - BMC Pregnancy Childbirth (2013)

Comparison of energy expenditure per week among groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750492&req=5

Figure 2: Comparison of energy expenditure per week among groups.
Mentions: Anxiety level was similar in both groups throughout pregnancy, being low/moderate (scores between 20 and 49) in the majority of women at the three evaluations. The Table 5 shows the percentages of the women who presented high and very high anxiety levels. Data related to the physical activities evaluated using the PPAQ, showed a difference between the groups regarding the energy expenditure of physical exercise, with increased (initial to final evaluation) in the BPP (1.4 MET-hrs/wk) and decreased in the CG (-0.3 MET-hrs/wk), with a significant difference between groups (p=0.009; Anova test). There was no difference between the groups regarding the other types of physical activity (Figure 2). The median increase in maternal weight between baseline and the final evaluation was similar in both groups, 8,5 kg (interquartile range–Q1: 6,2 kg; Q3: 11,8 kg) in the BPP group and 7,9 kg (Q1: 6,4 kg; Q3: 10,6 kg) in the control group (p=0.81, Mann–Whitney test; data not shown). Analysis of the participants’ adherence with the exercises to be performed at home was unfeasible because the women either failed to complete the exercise diary or failed to bring it with them on their return to the clinic. No adverse events associated with the exercise were reported by the participants. Regarding the analysis of the perinatal data, no difference was found between the groups, except for length of delivery (Table 6).

Bottom Line: 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 iparous women.Secondary outcomes were perinatal variables.The 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).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Caixa Postal 618113083-970, Campinas, São Paulo, Brazil.

ABSTRACT

Background: 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 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 iparous women.

Methods: A randomized controlled trial was conducted with 197 low risk iparous 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.

Results: The 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.

Conclusions: The 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 registration: Clinicaltrials.gov, (NCT01155804).

Show MeSH
Related in: MedlinePlus