Prevalence and risk factors of urinary incontinence during antenatal period in women delivering in a tertiary care center of Northern India

Abstract

INTRODUCTIONUrinary incontinence (UI) is a significant health concern and has been shown to impair women's activities and also affects the physical and mental health.1 UI is higher in few specific groups like pregnancy and have been reported a prevalence of 32%-64% for all UI and 59% for stress urinary incontinence (SUI) and 40% for mixed incontinence.2 Women with UI have poorer treatment seeking behavior for UI. Approximately 54.3% of all pregnant women have detrimental effects on quality of life.3 Pregnancy is an independent risk factor for UI that leads to weakened pelvic floor muscle because of pregnancy related physiological and anatomical changes. However, despite the multiple references in literature on effects of, parity, age of women, pathophysiological changes in pregnancy and mode of delivery, on the pelvic floor and lower urinary tract symptoms remain inconclusive. 4Prenatal physiological changes such as increasing pressure of the advancing gravid uterus and growing fetal weight on pelvic floor muscle (PFM) throughout the pregnancy, along with the pregnancy-related changing ABSTRACT Background: Urinary incontinence (UI) is a commonly encountered entity in antenatal and postpartum period. It is known to have detrimental effects on quality of life in approximately 54.3% of all pregnant women. However, the true prevalence of UI is still not known, especially in the South East Asia. This study has investigated the prevalence and risk factors of urinary incontinence during antenatal period. Methods: 500 women admitted in postnatal ward were interviewed retrospectively about the UI occurred during antenatal period, using questionnaire. The study was done over a period of six months. Detailed information regarding risk factors of urinary incontinence was included in questionnaire based on previous validated studies. Data was analyzed using SPSS 20 using chi square test. P value <0.05 was taken as significant. Results: Total 500 women were interviewed and based on questionnaire. 202 reported incontinence, thus giving a prevalence of 40.4%, out of that 192 (45.5%) had stress urinary incontinence (SUI), 40(19.8%) had urge urinary incontinence (UUI) and 70 (34.6%) had mixed incontinence. The risk factors like bladder infections and chronic cough had significant association with urinary incontinence. Advancing gestation had worsening effects on the symptoms of UI (p =0.000). Conclusions: Urinary incontinence is a common and neglected problem with poor treatment seeking behavior. SUI is more common in pregnant women than urge or mixed incontinence. Obstetricians need to ask have precise interrogation regarding UI in pregnant women to diagnose and treat the problem.