Regular Exercisers Have Stronger Pelvic Floor Muscles than Non-Regular Exercisers at Midpregnancy
Journal article, Peer reviewed
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- Artikler / Articles 
Original versionAmerican Journal of Obstetrics and Gynecology. 2018, 218, 427.e1-427.e5. 10.1016/j.ajog.2017.12.220
Background: Today, all healthy pregnant women are encouraged to be physically active throughout pregnancy, with recommendations to participate in at least 30 min of aerobic activity on most days of the week, in addition to perform strength training of the major muscle groups 2-3 days per week, and also pelvic floor muscle training. There is, however, an ongoing debate whether general physical activity enhances or declines pelvic floor muscle function. Objectives: To compare vaginal resting pressure, pelvic floor muscle strength and endurance in regular exercisers (exercise ≥ 30 minutes ≥ 3 times per week) and non-exercisers at mid-pregnancy. Furthermore, to assess whether regular general exercise or pelvic floor muscle strength was associated with urinary incontinence. Study design: This was a cross-sectional study at mean gestational week 20.9 (± 1.4) including 218 nulliparous pregnant women, mean age 28.6 years (range 19-40) and pre-pregnancy body mass index 23.9 kg/m2 (SD 4.0). Vaginal resting pressure, pelvic floor muscle strength and pelvic floor muscle endurance were measured by a high precision pressure transducer connected to a vaginal balloon. International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form was used to assess urinary incontinence. Differences between groups were analyzed using Independent Sample T-test. Linear regression analysis was conducted to adjust for pre-pregnancy body mass index, age, smoking during pregnancy and regular pelvic floor muscle training during pregnancy. P-value was set to ≤ 0.05. Results: Regular exercisers had statistically significant stronger ( mean 6.4 cm H2O (95% CI: 1.7, 11.2)) and more enduring ( mean 39.9 cm H2Osec (95% CI: 42.2, 75.7)) pelvic floor muscles. Only pelvic floor muscle strength remained statistically significant, when adjusting for possible confounders. Pelvic floor muscle strength and not regular general exercise was associated with urinary continence (adjusted B: -6.4 (95% CI: -11.5, -1.4)). Conclusion: Regular exercisers at mid pregnancy have stronger pelvic floor muscles than their sedentary counterparts. However, pelvic floor muscle strength and not regular general exercise was associated with urinary incontinence. There is a need for additional studies in elite athletes and women performing more strenuous exercise regimens.
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