Natural history of urinary incontinence from first childbirth to 30-months postpartum

Abstract

Purpose The objectives of this study were to determine the incidence of UI in a large cohort of primiparous women before and during pregnancy and over the course of 30 months postpartum, and to identify risk factors for UI during and after pregnancy. Methods Nulliparous women aged 18 to 35 years with singleton pregnancies were interviewed in their third trimester and asked about urinary incontinence before and during pregnancy (n = 3001). After delivery these women were interviewed at 1, 6, 12, 18, 24 and 30 months postpartum and asked about urinary incontinence occurring in the month prior to each interview. Multivariable logistic regression models identi ed risk factors for UI during pregnancy and during the follow-up period.Results Overall, 4% reported having urinary incontinence before pregnancy and 36.8% during pregnancy.The strongest predictor of urinary incontinence during pregnancy was urinary incontinence before pregnancy (adjusted OR 13.11,). Among the women with no subsequent pregnancies, the rate of urinary incontinence increased from 12.5% at 6 months postpartum to 27.4% at 30 months postpartum, 52.1% reported UI at one or more postpartum data collection stages, and the strongest predictors of postpartum UI were UI before pregnancy (adjusted OR 3.95 (95% CI 1.60-9.75) and during pregnancy (adjusted OR 4.36, 95% CI 3.24-5.87). ConclusionOur ndings suggest that primiparous women who report UI before and during pregnancy should be monitored for the continuation or worsening of UI over the course of the rst 2-3 years postpartum, and treatment options discussed.

The relationship between pelvic floor functions and vaginal microbiota in 6–8 weeks postpartum women

“…Previous studies showed that the incidences of abnormal pelvic floor functions and UI in postpartum women were (50–64%) and (23–32%), respectively, which were basically consistent with our results ( Qi et al, 2019 ; Yang et al, 2019 ; Patel et al, 2021 ). In this study, we concluded that more than half of (69.4%) postpartum women 6–8 weeks after delivery had abnormal pelvic floor functions, while the incidence of urinary incontinence UI was sharply lower (23.0%).…”

“…However, there were more risk factors for postpartum women with urinary incontinence. Considering that urinary incontinence is a symptom of severe pelvic floor dysfunction, the correlation of risk factors is more pronounced than symptomless women, but researches have so far proved inconclusive results about which factors (age, weight, delivery type, and fetal weight) wielded more influences on pelvic floor functions and the occurrence of UI ( Qi et al, 2019 ; Blomquist et al, 2020 ; Li et al, 2020 ; Fu et al, 2021 ; Patel et al, 2021 ).…”

Impact of Urinary Incontinence on Postpartum Sexual Function

“…This was a secondary analysis of a cross-sectional study of sexual dysfunction in participants who gave birth by any method (cesarean, spontaneous vaginal, or operative vaginal delivery) in the past 3 years. This period was chosen because recent data suggest that issues that may arise in the peripartum period, including incontinence, may persist for much longer than 1 year after delivery 5,13 . Qualtrics XM (Seattle, WA), an online survey platform, was engaged to recruit and survey 600 participants in Ohio, Pennsylvania, and Michigan to evaluate sexual function after birth.…”

“…This period was chosen because recent data suggest that issues that may arise in the peripartum period, including incontinence, may persist for much longer than 1 year after delivery. 5,13 Qualtrics XM (Seattle, WA), an online survey platform, was engaged to recruit and survey 600 participants in Ohio, Pennsylvania, and Michigan to evaluate sexual function after birth. Qualtrics leverages multiple sample sources to recruit populations that are challenging to recruit otherwise, such as minority populations and those who may not be comfortable discussing certain conditions in a clinical setting; surveys are administered electronically via email.…”

Guidelines for Prenatal and Postpartum Resistance Training

“…Urinary incontinence, or the involuntary leaking of urine, becomes more likely in the third trimester. An estimated 37% of women experience urinary incontinence during pregnancy and it is most common in the third trimester [24]. Running and jumping will increase the incidence of urinary incontinence during pregnancy as it significantly increases the stress on the pelvic floor [2] which is already undergoing increased stress from the weight of the uterus and growing fetus.…”