Association between Stress Urinary Incontinence and Depressive Symptoms after Birth: the Czech ELSPAC Study

Abstract

The study objectives were to (1) identify risk factors related to stress urinary incontinence (SUI) and postnatal depression (PD) after birth, and (2) investigate both possible directions of association between SUI and PD in population-based sample of Czech mothers. 3,701 nulliparous and multiparous women completed the self-reported questionnaires at 6 weeks and 6 months after birth and were included into the analyses of this prospective cohort study. Unadjusted and adjusted logistic regressions examined relationship between SUI a PD accounting for range of other risk factors. During the first 6 months after birth, 650 mothers (17.6%) developed SUI and 641 (17.3%) displayed signs of PD. The mode of delivery, parity and higher BMI were associated with SUI. The rate of PD symptoms was higher in mothers with positive history of prenatal depression, and in divorced or widowed mothers. Both conditions were associated with worse self-reported health, back pain and stop-smoker status. initially, SUI at 6 weeks was slightly, but significantly associated with onset of PD at 6 months (OR 1.51, 95% CI 1.02-2.23) while PD at 6 weeks was not significantly related to new cases of SUI at 6 months (OR 1.48, 95% CI 0.91-2.39). After full adjustment these OR reduced to 1.41 and 1.38 (both non-significant), respectively. SUi and pD are common conditions in women postpartum that share some risk factors. Our study suggests that both directions of their relationship are possible although a larger study is needed to confirm our findings.Urinary incontinence is a commonly experienced health problem in women after delivery. Its prevalence ranges between 18 and 34% 1 . Multiple studies showed that a vaginal delivery is the most significant postpartum urinary incontinence contributor 2 . Other suggested risk factors included increased maternal age, body mass index and parity 3 . In most cases urinary incontinence regresses spontaneously or after rehabilitation of the pelvic floor muscles. However, a substantial number of women with postpartum urinary incontinence are affected in the long term 4 . Postpartum urinary incontinence together with other health related problems such as tiredness, back pain, sexual problems, and relationship difficulties may contribute to the development of depressive symptoms 5 .Transient mood disorders after birth are common but usually subside relatively quickly without any long term adverse effects 6 . Postpartum depression, on the other hand, is more severe mood disorder with a potential long term effect on mothers´ quality of life 7 . Its prevalence ranges from 5.2% to 13.0% in developed countries 8 and can reach up to 20% in mothers from low and middle income countries 9 . In addition, some authors suggested that the rates reported in some studies were underestimated and would be higher if a standardized screening tool for depression in mothers after birth had been applied 10 . The main covariates for postnatal depression include

Is there an association between parity and urinary incontinence in women during pregnancy and the first year postpartum?: A systematic review and meta‐analysis

“…Juraskova et al 55 examined the risk of SUI with increasing parity in a cohort of 3701 women in a cross‐sectional study. Women with two (unadjusted OR: 1.33 [1.11–1.59]), three (unadjusted OR: 1.58 [1.17–2.14]), and four or more children (unadjusted OR: 2.48 [1.54–4.00]) were more likely to experience SUI.…”

Effects of Tolterodine on Depression, Anxiety, Learning and Memory in Mice

“…Many previous studies have shown that there is a relationship between OAB and depression [17]. It has been observed that the frequency of OAB symptoms such as urge incontinence and nocturia is increased in individuals with high levels of anxiety and depression [18]. The opposite is also true.…”

Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women

“…Abnormality in serotonin is a plausible explanation for both depression and incontinence development. Involuntary leakage of urine can be bothersome, lead to anxiety, and subsequently contribute to social isolation and depression development 19 . In addition, increased sympathetic nervous system activity associated with depression may increase circulating levels of cortisol and catecholamines and, consequently, lead to physiologic changes in the bladder and UI 2 .…”