{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:31:30Z","timestamp":1792621890224,"version":"4.5.0"},"reference-count":72,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T00:00:00Z","timestamp":1703289600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The complex process of pregnancy and childbirth significantly influences the well\u2010being of both mother and child. Today all pregnant women without medical contraindications are recommended to start or continue regular aerobic and strength training for at least 150\u2009min per week to prevent pregnancy\u2010related diseases and conditions. Urinary incontinence in pregnancy, episiotomy and third\u2010 or fourth\u2010degree perineal tear during labor can greatly impact womens\u2019 health, quality of life and ability to be physically active. The aim of this study was to examine the efficacy of pelvic floor muscle training (PFMT) during pregnancy in the prevention of urinary incontinence, episiotomy, and third\u2010 or fourth\u2010degree perineal tear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A systematic review and meta\u2010analysis (CRD42022370600) was performed. Only randomized clinical trials published between 2010 and 2023 were included. The following databases were examined: EBSCO (including Academic Search Premier, Education Resources Information Center, MEDLINE, SPORTDiscus and OpenDissertations databases), <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">Clinicaltrials.gov<\/jats:ext-link>, Web of Science, Scopus, Cochrane Database of Systematic Reviews and Physiotherapy Evidence Database (PEDro). Three meta\u2010analyses to investigate the effect of PFMT exclusively or implemented as a section within a physical activity program during pregnancy on urinary incontinence, episiotomy, and third\u2010 or fourth\u2010degree perineal tear were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty studies were analyzed (<jats:italic>N<\/jats:italic>\u2009=\u20096691). An effective preventive action of PFMT was found for urinary incontinence (<jats:italic>z<\/jats:italic>\u2009=\u20093.46; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0005; relative risk [RR]\u2009=\u20090.72, 95% confidence interval [CI]:\u20090.59, 0.87, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200959%) and third\u2010 or fourth\u2010degree perineal tear (<jats:italic>z<\/jats:italic>\u2009=\u20092.89; <jats:italic>p<\/jats:italic>\u2009=\u20090.004; RR\u2009=\u20090.50, 95% CI:\u20090.31, 0.80, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200948%) but not for episiotomy (<jats:italic>z<\/jats:italic>\u2009=\u20090.80; <jats:italic>p<\/jats:italic>\u2009=\u20090.42; RR\u2009=\u20090.95, 95% CI:\u20090.85, 1.07, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200975%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PFMT during pregnancy proves to be an effective preventive intervention for reducing the risk of urinary incontinence and the occurrence of third\u2010 or fourth\u2010degree perineal tears. These findings highlight the importance of incorporating PFMT into antenatal care and training programs to improve maternal well\u2010being and overall childbirth outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14744","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T08:45:15Z","timestamp":1703321115000},"page":"1015-1027","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Influence of pelvic floor muscle training alone or as part of a general physical activity program during pregnancy on urinary incontinence, episiotomy and third\u2010 or fourth\u2010degree perineal tear: Systematic review and meta\u2010analysis of randomized clinical trials"],"prefix":"10.1111","volume":"103","author":[{"given":"Dingfeng","family":"Zhang","sequence":"first","affiliation":[{"name":"AFIPE Research Group Universidad Polit\u00e9cnica de Madrid  Madrid 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