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2019 Canadian guideline for physical activity throughout pregnancy
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  • Published on:
    Comment and questions to Mottola et al (2019): 2019 Canadian guideline for physical activity throughout pregnancy
    • Kari , Professor, PhD Norwegian School of Sport Sciences. Department of Sports Medicine

    Letter to the Editors
    Br J Sports Med
    J Obstet Gynecol Canada
    Oslo, Nov 23rd 2018
    Comment and questions to Mottola et al (2019): 2019 Canadian guideline for physical activity throughout pregnancy
    We have read the Canadian guideline for physical activity throughout pregnancy with great interest. We note that the guideline team have made their recommendation regarding pelvic floor muscle training (PFMT) based on evidence from a systematic review from the same research group (Davenport et al 2018). The main results of this review are in line with the latest Cochrane review (Woodley et al 2017) on the same topic; while there are some methodological differences and variations in which studies were included or not (two of the largest studies on PFMT was left out from the Davenport review; Mørkved et al 2003 and Stafne et al 2012), the findings in terms of size and precision of effect are similar, although Davenport et al used odds ratio and Woodley et al used risk ratio for their summary statistic. Davenport et al reported that PFMT gave a 50% reduction in prenatal UI and a 35% reduction in postnatal UI, but the guideline team concluded a “weak recommendation” for PFMT because UI was not rated as a "critical outcome" and the evidence was of "low quality". We find this conclusion at odds with the evidence and the interpretation of the evidence based on the guideline team’s own criteria.
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    Conflict of Interest:
    None declared.