OBJECTIVE: To investigate the risk factors for postpartum urinary incontinence (UI) and its characteristics. METHOD: This was a case-control study with 344 puerperal women (77 cases and 267 controls) with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. RESULTS: Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, p<0.0001), multiparity (OR 2.26, CI 95% 1.22 - 4.19, p=0.009), gestational age at birth greater or equal to 37 weeks (OR 2.52, CI 95% 1.16 - 5.46, p=0.02) and constipation (OR 1.94, CI 95% 1.05 - 5.46, p=0.035). CONCLUSION: Most often, UI first appeared during pregnancy and remained through the postpartum period. Urinary incontinence during pregnancy, multiparity, gestational age at birth greater or equal to 37 weeks, and constipation were presented as risk factors. In the studied group, stress UI was more frequent.
This case-control study evaluated whether UI in the puerperium compromises the health-related quality of life (HRQoL) and if so, in which aspects. The study included 344 women (77 case group and 267 control group) up to 90 days postpartum, who were attended the Obstetrics Outpatient Clinic of a public teaching hospital, for the postpartum follow up consultation. A socio-demographic and clinical data questionnaire formulated and validated for the study, the International Consultation on Incontinence Questionnaire - Short-Form (ICIQ-SF), the King's Health Questionnaire (KHQ) and the Medical Outcomes Study 36 - Item Short Form Health Survey (SF-36), were applied. The mean score of the ICIQ-SF was 13.9 (SD: 3.7). The case group presented high mean scores in the domains Impact of the Incontinence, Emotions, Daily Activity Limitations and Physical Limitations, of the KHQ. The groups differed significantly in the domains Physical Aspects, Pain, General Health Status, Vitality, Social Aspects and Mental Health of the SF-36. It is concluded that UI significantly affects the physical and mental health of puerperae.
Revisão bibliográfica que objetivou identificar as associações entre a incontinência urinária feminina e os aspectos raciais. Utilizaram-se as bases de dados MEDLINE e LILACS para pesquisa dos artigos publicados nos anos de 2003 a 2010. Analisou-se 30 publicações que apontaram diversas relações entre incontinência e raça. A prevalência de incontinência foi maior entre brancas. A incontinência urinária de esforço foi mais frequente entre brancas e a de urgência, entre negras. Brancas e asiáticas apresentam perda urinária em menor quantidade comparado a negras e hispânicas. O impacto na qualidade de vida esteve mais relacionado à severidade da perda urinária e outros fatores, do que especificamente à questão racial. Brancas apresentaram melhor conhecimento sobre incontinência e se submeteram mais frequentemente a tratamento cirúrgico para incontinência urinária de esforço. Brancas e latinas apresentam maior risco de incontinência urinária que negras e asiáticas. Ressalta-se a necessidade de estudos brasileiros para que os dados possam ser adequados à nossa realidade.
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