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Preventing urinary incontinence during pregnancy and postpartum: a review

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Abstract

Urinary incontinence (UI) is a common condition in association with pregnancy. Incident UI in pregnancy or postpartum are significant risk factors for UI later in life. Epidemiological studies on UI during pregnancy and postpartum list numerous variables associated with UI. For women, the main focus is on pelvic floor muscle training to prevent UI. However, several other modifiable risk factors are likely to contribute to prevention of UI during pregnancy and postpartum. This review investigated modifiable risk factors for UI during pregnancy and postpartum and also reviewed randomized controlled trials on prevention of UI in association with pregnancy. Systematic searches for publications until September 2012 on prevention of UI during pregnancy and postpartum were performed. Based on available evidence, the following recommendations to prevent UI during pregnancy and postpartum were made: women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations are addressed in association with pregnancy, incidence of UI during pregnancy and postpartum is likely to decrease.

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Conflicts of interest

Stian Langeland Wesnes: none. Gunnar Lose has been a consultant for Contura, contributed with trial participation for Pfizer, been a consultant and honorarium speaker for Astella, done research collaboration with Coloplast and contributed in workshops for Johnson & Johnson.

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  1. Research Group for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018, Bergen, Norway

    Stian Langeland Wesnes

  2. Department of Obstetrics and Gynecology, Copenhagen University, Hospital Herlev, Herlev, Denmark

    Gunnar Lose

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  1. Stian Langeland Wesnes
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  2. Gunnar Lose
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Correspondence to Stian Langeland Wesnes.

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A related article can be found at doi:10.1007/s00192-013-2061-7.

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Wesnes, S.L., Lose, G. Preventing urinary incontinence during pregnancy and postpartum: a review. Int Urogynecol J 24, 889–899 (2013). https://doi.org/10.1007/s00192-012-2017-3

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