The association between the interdelivery interval and early postpartum urinary incontinence in women who had consecutive vaginal deliveries: a retrospective cohort study

Abstract

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.

Development and validation of a Decision‐Making Ability Scale for postpartum urinary incontinence women engaging in pelvic floor physical therapy

“…Postpartum urinary incontinence (PPUI) is when urine uncontrollably leaks after delivery 1 due to the overexpansion of the pelvic floor ligaments and muscles during pregnancy and vaginal delivery, which relaxes the tissues supporting the urinary bladder floor and upper urethra. 2,3 It affects ~12.50% at 6 weeks postpartum and 6.8% at 6 months postpartum. 4 PPUI not only affects women's physical wellbeing but also their psychology and social economy.…”