Based on current literature, evidence stating that PUR is harmless is lacking. Future research should focus on management strategies for overt PUR and the long-term consequences of covert PUR. Until these results are available, clinicians should be aware of the potential consequences and therefore keep trying to identify patients at risk of PUR and patients with the actual condition.

Background Postpartum urinary retention (PUR) is a common condition with varying prevalence. Measurement of the post-void residual volume (PVRV) is not regularly performed. Various studies have been published on overt (the inability to void after giving birth, requiring catheterisation) and covert (an increased PVRV after spontaneous micturition) PUR. To evaluate which clinical prognostic factors are related to PUR, the identification of independent risk factors for covert and overt PUR is needed.Objectives We performed a systematic review and meta-analysis of observational studies reporting on risk factors for PUR.Search strategy Systematic search of MEDLINE and EMBASE to September 2011.Selection criteria Articles that reported on women diagnosed with PUR or with an abnormal PVRV.Data collection and analysis The included articles were selected by two authors. We constructed two-by-two tables for potential risk factors of overt and covert PUR and calculated pooled odds ratios (ORs) with 95% confidence intervals.Main results Twenty-three observational studies with original data were eligible for data extraction, of which 13 could be used for meta-analysis. Statistically significant risk factors for overt PUR were epidural analgesia (OR 7.7), instrumental delivery (OR 4.5), episiotomy (OR 4.8) and primiparity (OR 2.4). For covert PUR, variety in the definitions used resulted in heterogeneity; no significant prognostic factors were found.Conclusions Instrumental delivery, epidural analgesia, episiotomy and nulliparity are statistically significantly associated with a higher incidence of overt PUR. The same factors were identified for covert PUR, but without statistical significance. Uniformity in definitions in future research is essential to create a prognostic model.

investors a shift in emphasis should be made to focus on the fact that good outcomes benefit everyone.A stronger consensus concerning priority funding areas for research and development is needed. Its absence provides the opportunity to educate funders and forge a more cohesive research agenda. The funders also recognize the need to educate others about the definition, importance, and aspects of healthy pregnancy and the consequences of adverse pregnancy outcomes. Varying opinions regarding the coordination of funding and a funding review process were present among the GAPPS team.From the findings of the GAPPS, the authors compiled a set of recommendations to improve the visibility of research focusing on pregnancy, childbirth, and early life to aid with the mobilization of funders. These recommendations are based on the premise that healthy pregnancies benefit everyone. An alliance of funders, researchers, and key stakeholders should be established. Advocacy of awareness of the magnitude of prematurity, stillbirth, and childhood problems can be advanced by the economic modeling of the true costs of prematurity. Finding common ground among funding organizations will advance the establishment of coordinated research funding and the promotion of research opportunities. Finally, coordination of pregnancy-specific biobanks and harmonization of data collection will advance the development and coordination of an international research infrastructure. The end goal is for every pregnancy to be a healthy pregnancy.