{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:16:33Z","timestamp":1787613393136,"version":"build-2736575974"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"NTNU Norwegian University of Science and Technology"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction and hypothesis<\/jats:title>\n                <jats:p>Urinary incontinence is common postpartum. Our aims were to assess whether antenatal exercise including pelvic floor muscle training (PFMT) has long-term effects on urinary incontinence (UI) and to explore factors associated with UI 7 years postpartum.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A follow-up of a two-centre randomized controlled trial performed at St. Olavs Hospital and Stavanger University Hospital, Norway. In the original trial women were randomized to a 12-week structured exercise protocol including PFMT or standard antenatal care during pregnancy. Link to an electronic questionnaire was sent by postal mail 7 years postpartum. Prevalence of UI was assessed with Sandvik severity index and compared between groups. Factors associated with UI were studied using multivariable logistic regression analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The response rate was 35% (298\/855). UI was reported by 78 (51%) in the intervention group and 63 (57%) in the control group (<jats:italic>p<\/jats:italic>\u2009=\u20090.539). In the multivariable logistic regression analyses, women with UI at inclusion had a five-fold increase in odds of UI at 7 years (OR 5.4, 95% CI 2.6, 11.5). Engaging in regular exercise was not significantly associated with UI at 7 years; however, UI was associated with lower exercise intensity (OR 2.4, 95% CI 1.2, 4.6).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We found no group differences of antenatal exercise including PFMT on UI after 7 years among the responders. UI in pregnancy increased the risk of long-term UI. Regular exercise was not associated with UI at 7 years; however, women with UI were more than twice as likely to exercise at lower intensity than continent women.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00192-021-05028-x","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T14:02:38Z","timestamp":1640181758000},"page":"1557-1565","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Antenatal pelvic floor muscle training and urinary incontinence: a randomized controlled 7-year follow-up study"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4922-477X","authenticated-orcid":false,"given":"Signe Nilssen","family":"Stafne","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecka","family":"Dalbye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oda M.","family":"Kristiansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne E.","family":"Hjelle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kjell \u00c5smund","family":"Salvesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siv","family":"M\u00f8rkved","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hege H\u00f8lmo","family":"Johannessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"issue":"1","key":"5028_CR1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1002\/nau.20798","volume":"29","author":"BT Haylen","year":"2010","unstructured":"Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN. An International Urogynecological Association (IUGA)\/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4\u201320. https:\/\/doi.org\/10.1002\/nau.20798.","journal-title":"Neurourol Urodyn"},{"key":"5028_CR2","volume-title":"Incontinence","author":"I Milsom","year":"2017","unstructured":"Milsom I, Altman D, Cartwright R, Lapitan MC, Nelson R, Sj\u00f6str\u00f6m S, Tikkinen K. Epidemiology of urinary incontinence (UI) and other lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP) and anal (AI) incontinence. In: Abrams P, Cardozo L, Wagg A, Wein A, editors. Incontinence, vol. 1. 6th ed. Tokyo: International Continence Society; 2017.","edition":"6"},{"issue":"5","key":"5028_CR3","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1007\/s001920200061","volume":"13","author":"L Hvidman","year":"2002","unstructured":"Hvidman L, Foldspang A, Mommsen S, Bugge Nielsen J. Correlates of urinary incontinence in pregnancy. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(5):278\u201383. https:\/\/doi.org\/10.1007\/s001920200061.","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"5028_CR4","doi-asserted-by":"publisher","unstructured":"Delancey JO, Kane Low L, Miller JM, Patel DA, Tumbarello JA.\u00a0Graphic integration of causal factors of pelvic floor disorders: an integrated life span model. Am J Obstet Gynecol. 2008;199(6):610 e611\u2013615. https:\/\/doi.org\/10.1016\/j.ajog.2008.04.001.","DOI":"10.1016\/j.ajog.2008.04.001"},{"issue":"3","key":"5028_CR5","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.jphys.2020.06.011","volume":"66","author":"K B\u00f8","year":"2020","unstructured":"B\u00f8 K. Physiotherapy management of urinary incontinence in females. J Phys. 2020;66(3):147\u201354. https:\/\/doi.org\/10.1016\/j.jphys.2020.06.011.","journal-title":"J Phys"},{"issue":"2","key":"5028_CR6","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1007\/s00192-016-3123-4","volume":"28","author":"K B\u00f8","year":"2016","unstructured":"B\u00f8 K, Frawley HC, Haylen BT, Abramov Y, Almeida FG, Berghmans B, Bortolini M, Dumoulin C, Gomes M, McClurg D, Meijlink J, Shelly E, Trabuco E, Walker C, Wells A. An International Urogynecological Association (IUGA)\/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J. 2016;28(2):191\u2013213. https:\/\/doi.org\/10.1007\/s00192-016-3123-4.","journal-title":"Int Urogynecol J"},{"key":"5028_CR7","doi-asserted-by":"publisher","unstructured":"Dumoulin C, Cacciari LP, Hay-Smith EJC.\u00a0Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;(10). https:\/\/doi.org\/10.1002\/14651858.CD005654.pub4.","DOI":"10.1002\/14651858.CD005654.pub4"},{"key":"5028_CR8","doi-asserted-by":"publisher","unstructured":"Woodley SJ, Lawrenson P, Boyle R, Cody JD, Morkved S, Kernohan A, Hay-Smith EJC.\u00a0Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2020;5:CD007471. https:\/\/doi.org\/10.1002\/14651858.CD007471.pub4.","DOI":"10.1002\/14651858.CD007471.pub4"},{"issue":"8","key":"5028_CR9","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1111\/j.1471-0528.2008.01742.x","volume":"115","author":"WI Agur","year":"2008","unstructured":"Agur WI, Steggles P, Waterfield M, Freeman RM. The long-term effectiveness of antenatal pelvic floor muscle training: eight-year follow up of a randomised controlled trial. Bjog. 2008;115(8):985\u201390. https:\/\/doi.org\/10.1111\/j.1471-0528.2008.01742.x.","journal-title":"Bjog"},{"issue":"10","key":"5028_CR10","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1111\/j.1471-0528.2012.03426.x","volume":"119","author":"SN Stafne","year":"2012","unstructured":"Stafne SN, Salvesen KA, Romundstad PR, Torjusen IH, M\u00f8rkved S. Does regular exercise including pelvic floor muscle training prevent urinary and anal incontinence during pregnancy? A randomised controlled trial Bjog. 2012;119(10):1270\u201380. https:\/\/doi.org\/10.1111\/j.1471-0528.2012.03426.x.","journal-title":"A randomised controlled trial Bjog"},{"key":"5028_CR11","doi-asserted-by":"publisher","unstructured":"Johannessen HH, Fr\u00f8shaug BE, Lys\u00e5ker PJG, Salvesen K\u00c5, Lukasse M, M\u00f8rkved S, Stafne SN.\u00a0Regular antenatal exercise including pelvic floor muscle training reduces urinary incontinence three months postpartum \u2013 follow-up of a randomised controlled trial. Acta Obstet Gynecol Scand. 2020;n\/a(n\/a). https:\/\/doi.org\/10.1111\/aogs.14010.","DOI":"10.1111\/aogs.14010"},{"issue":"1","key":"5028_CR12","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1097\/AOG.0b013e3182393f86","volume":"119","author":"SN Stafne","year":"2012","unstructured":"Stafne SN, Salvesen K, Romundstad PR, Eggeb\u00f8 TM, Carlsen SM, M\u00f8rkved S. Regular exercise during pregnancy to prevent gestational diabetes: a randomized controlled trial. Obstet Gynecol. 2012;119(1):29\u201336. https:\/\/doi.org\/10.1097\/AOG.0b013e3182393f86.","journal-title":"Obstet Gynecol"},{"issue":"2","key":"5028_CR13","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1097\/00003081-200306000-00028","volume":"46","author":"ACOG","year":"2003","unstructured":"ACOG. Exercise during pregnancy and the postpartum period. Clin Obstet Gynecol. 2003;46(2):496\u20139.","journal-title":"Clin Obstet Gynecol"},{"key":"5028_CR14","doi-asserted-by":"crossref","unstructured":"B\u00f8 KM S. Pelvic floor and exercise science. In: B\u00f8 KB B, M\u00f8rkved S, Van Kampen M (editors) Evicence-based physical therapy for the pelvic floor. Bridging science and clinical practice. Elsevier. 2015.","DOI":"10.1016\/B978-0-7020-4443-4.00001-7"},{"key":"5028_CR15","doi-asserted-by":"publisher","unstructured":"Sandvik H, Seim A, Vanvik A, Hunskaar S. A severity index for epidemiological surveys of female urinary incontinence: comparison with 48-hour pad-weighing tests. Neurourol Urodyn. 2000;19(2):137\u201345.\u00a0https:\/\/doi.org\/10.1002\/(sici)1520-6777(2000)19:2<137::Aid-nau4>3.0.Co;2-g.","DOI":"10.1002\/(sici)1520-6777(2000)19:2<137::Aid-nau4>3.0.Co;2-g"},{"key":"5028_CR16","unstructured":"M\u00f8rkved S, B\u00f8 K.\u00a0Urinary incontinence related to the peripartum periode. In: B\u00f8 K, Berghmans B, M\u00f8rkved S, van Kampen M (editors) evidence-based physical therapy for the pelvic floor. Bridging science and clinical practice. 2 edn. Elsevier; 2015. pp 208-226."},{"key":"5028_CR17","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1093\/ptj\/pzx006","volume":"97","author":"H Frawley","year":"2017","unstructured":"Frawley H, Dean SG, Slade SC, Hay-Smith EJ. Is pelvic-floor muscle training a physical therapy or a behavioral therapy? A call to name and report the physical, cognitive, and behavioral elements. Phys Ther. 2017;97:425\u201337.","journal-title":"Phys Ther"},{"issue":"8","key":"5028_CR18","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1002\/nau.22498","volume":"33","author":"A-C Pizzoferrato","year":"2014","unstructured":"Pizzoferrato A-C, Fauconnier A, Quiboeuf E, Morel K, Schaal J-P, Fritel X. Urinary incontinence 4 and 12 years after first delivery: risk factors associated with prevalence, incidence, remission, and persistence in a cohort of 236 women. Neurourol Urodyn. 2014;33(8):1229\u201334. https:\/\/doi.org\/10.1002\/nau.22498.","journal-title":"Neurourol Urodyn"},{"issue":"2","key":"5028_CR19","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1097\/01.AOG.0000226860.01127.0e","volume":"108","author":"L Viktrup","year":"2006","unstructured":"Viktrup L, Rortveit G, Lose G. Risk of stress urinary incontinence twelve years after the first pregnancy and delivery. Obstet Gynecol. 2006;108(2):248\u201354. https:\/\/doi.org\/10.1097\/01.AOG.0000226860.01127.0e.","journal-title":"Obstet Gynecol"},{"issue":"5","key":"5028_CR20","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1111\/j.1471-0528.2008.02107.x","volume":"116","author":"SL Wesnes","year":"2009","unstructured":"Wesnes SL, Hunskaar S, B\u00f8 K, R\u00f8rtveit G. The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort study Bjog. 2009;116(5):700\u20137. https:\/\/doi.org\/10.1111\/j.1471-0528.2008.02107.x.","journal-title":"A cohort study Bjog"},{"key":"5028_CR21","unstructured":"Statistics Norway.\u00a0Helseforhold, levek\u00e5rsunders\u00f8kelsen.\u00a02015.\u00a0\u00a0https:\/\/www.ssb.no\/statbank\/table\/06181\/. Accessed 15 Mar 2021."},{"issue":"3","key":"5028_CR22","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s40279-019-01243-1","volume":"50","author":"K B\u00f8","year":"2020","unstructured":"B\u00f8 K, Nygaard IE. Is physical activity good or bad for the female pelvic floor? A Narrative Review Sports Med. 2020;50(3):471\u201384. https:\/\/doi.org\/10.1007\/s40279-019-01243-1.","journal-title":"A Narrative Review Sports Med"},{"issue":"5","key":"5028_CR23","doi-asserted-by":"publisher","first-page":"e140","DOI":"10.1097\/AOG.0000000000002633","volume":"131","author":"ACOG Committee Opinion No. 736: Optimizing Postpartum Care","year":"2018","unstructured":"ACOG Committee Opinion No. 736: Optimizing Postpartum Care. Obstet Gynecol. 2018;131(5):e140\u201350. https:\/\/doi.org\/10.1097\/AOG.0000000000002633.","journal-title":"Obstet Gynecol"},{"key":"5028_CR24","unstructured":"Government A.\u00a0National Women's Health Strategy 2020\u20132030.\u00a02018."}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-021-05028-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-021-05028-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-021-05028-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T09:04:09Z","timestamp":1655543049000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-021-05028-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,22]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["5028"],"URL":"https:\/\/doi.org\/10.1007\/s00192-021-05028-x","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,22]]},"assertion":[{"value":"6 September 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}