Background Stress urinary incontinence (SUI) is a common public health issue that negatively impacts the quality of life for women worldwide, of which early detection and rehabilitation are consequently pivotal. The aim of this study is to establish a simple nomogram for identifying women at risk of postpartum SUI. Methods A retrospective study was conducted in a tertiary specialized hospital in Shanghai, China. The study included only women with singleton, full-term, and vaginal deliveries. 2,441 women who delivered from July 2019 to November 2019 were included in the training cohort, and 610 women who delivered from January 2022 to February 2022 were included in the validation cohort. SUI was determined by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). Univariate and multifactorial logistical regression were used to identify independent risk factors for postpartum SUI and further construct the nomogram accordingly. Based on concordance statistics (C-statistics), calibration curves, and decision curve analyses, we evaluated the performance of the nomogram in the training cohort and the validation cohort. In addition, the model was validated internally in the training cohort through cross-validation. Results There were no significant statistically differences in important baseline data such as age, pre-pregnancy BMI, and parity between the training and validation cohorts. SUI was observed in 431 (17.6%) and 125 (20.5%) women in the training and validation cohorts, respectively. According to the regression analysis, age, parity, second stage of labor, infant weight, and forceps delivery were included in the nomogram. The nomogram had a C-statistic of 0.80 (95% confidence interval [CI] 0.74–0.85) for predicting SUI. C-statistics were stable in both internally cross-validated training cohort (mean 0.81) and validation cohort (0.83 [95% CI 0.79–0.87]). The nomogram’s calibration curve was near the ideal diagonal line. Additionally, the model exhibited a positive net benefit from the decision curve analysis. Conclusion We have created a nomogram that can be utilized to quantify the risk of postpartum SUI for women with vaginal delivery. The model might contribute to predicting early postpartum SUI, thereby facilitating the management of SUI.

Background Urinary incontinence (UI) is associated with obstetric-related factors; however, the association between the timing of deliveries and UI remains unclear. We examined the association between the interdelivery interval (IDI) and early postpartum UI. Methods This retrospective cohort study included 2,492 parous women who had consecutive singleton, full-term, and vaginal deliveries. UI was self-reported by the participants from 42 to 60 days postpartum and was classified using the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form. The IDI was measured as the number of months between 2 consecutive live births, and the participants were divided into 4 groups based on the IDI quartiles. The associations between the IDI and early postpartum UI were assessed using multiple logistic regression models. Results The median [interquartile range] IDI for the entire cohort was 62 [40–90] months at the baseline. In general, the restricted cubic splines showed a U-shaped curve association between the IDI and the incidence of early postpartum UI. After fully adjusting for potential confounders, a longer IDI was associated with a lower adjusted odds ratio (aOR) of postpartum UI. Among the 4 groups, the Quartile 3 IDI group had the lowest aOR [aORQuartile 1–Quartile 2: 0.48 (95% CI: 0.36–0.63); aORQuartile 1–Quartile 3: 0.37 (95% CI: 0.27–0.49); aORQuartile 1–Quartile 4: 0.40 (95% CI: 0.28–0.57); the P value for the trend was <0.001). The association between the IDI and UI was more pronounced in the younger women (<35 years old) and the women with a pre-pregnancy body mass index of <25 kg/m 2 (the P values for both interactions were <0.01). Conclusions We found that the IDI was independently associated with the incidence of early postpartum UI in parous women. IDI ≥41 months was associated with a lower risk of postpartum UI compared to IDI <41 months.

Purpose This study sought to explore the obstetric factors affecting early postpartum pelvic floor function of primiparas after vaginal delivery. Patients and Methods We included 3362 primiparas who underwent postpartum re-examination in International Peace Maternity and Child Health Hospital at 42–60 days after delivery. The Glazer Protocol was used to evaluate their pelvic floor function, and univariate and multivariate logistic regression analyses were performed to identify obstetric factors that might affect it. Results Forceps-assisted delivery significantly increased the risk of the decline in fast- and slow-twitch muscle strength in the early postpartum period when compared with natural vaginal delivery (P < 0.05). Women with a pre-pregnancy body mass index (BMI) of ≥18.5 kg/m 2 had a decreased risk of decline in fast-twitch muscle strength than those with a pre-pregnancy BMI of <18.5 kg/m 2 (P < 0.05). Women who had a pre-pregnancy BMI of 24.0 to <28.0 kg/m 2 bore a decreased risk of decline in slow-twitch muscle strength than those with a pre-pregnancy BMI of <18.5 kg/m 2 (P < 0.05). The risk of decline in fast-twitch muscle strength and slow-twitch muscle in women with anemia during pregnancy was significantly increased (P < 0.05); women with second-stage labors of >2 h had an increased risk of fast-twitch and slow-twitch muscle strength decline than those with <2 h (P < 0.05). Conclusion Both pre-pregnancy underweight and obesity may cause impairment of early postpartum pelvic floor function. Forceps delivery, anemia during pregnancy, and the length of second stage of labor are independent factors leading to pelvic floor function impairment.

Background: Forceps-assisted vaginal delivery is closely associated with postpartum pelvic floor muscle (PFM) injury and postpartum pelvic floor dysfunction. The present study utilized Glazer PFM surface electromyography (sEMG) and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF) for the objective assessment of postpartum PFM function to determine the effects of different forceps delivery indications on early postpartum pelvic floor function in primiparas. Methods: Four hundred primiparas whose pregnancies had been terminated by forceps delivery were divided into three groups based on the indication for forceps delivery: fetal distress (FD) (n = 260), prolonged second stage of labor (PSSL) (n = 30), and intrapartum fever combined with fetal distress (IFFD) (n = 110). Pelvic floor muscle surface electromyography (EMG) performed according to the Glazer protocol at 42-60 days postpartum was the primary outcome measure. Results: The overall Glazer assessment scores of the PSSL (54.4 ± 18.6) and IFFD (54.6 ± 15.8) groups were significantly lower than that of the FD group (59.3 ± 17.0) (p = 0.019). The peak EMG value during the fast-twitch stage for the FD, PSSL, and IFFD groups was 32.4 ± 17.7, 31.7 ± 26.1, and 26.5 ± 12.2 µV, respectively; the IFFD and FD groups were significantly different (p < 0.05). The incidence of postpartum stress urinary incontinence (SUI) was significantly higher in the IFFD and PSSL groups; the IFFD and FD groups were significantly different (p < 0.05). Conclusions: Intrapartum fever probably affects the early postpartum pelvic floor function of primiparas who underwent forceps delivery, which mainly manifests in the short term as reduced fast-twitch muscle strength and SUI.