Maternal risk factors of urinary incontinence during pregnancy and postpartum: A prospective cohort study

Anna Rajavuori; Jussi P Repo; Arja Häkkinen; Pirkko Palonen; Juhani Multanen; Pauliina Aukee

doi:10.1016/j.eurox.2021.100138

Maternal risk factors of urinary incontinence during pregnancy and postpartum: A prospective cohort study

Eur J Obstet Gynecol Reprod Biol X. 2021 Nov 8:13:100138. doi: 10.1016/j.eurox.2021.100138. eCollection 2022 Jan.

Authors

Anna Rajavuori¹, Jussi P Repo², Arja Häkkinen^{3

4}, Pirkko Palonen⁴, Juhani Multanen^{3

4}, Pauliina Aukee⁵

Affiliations

¹ Department of Obstetrics and Gynecology, Turku University Hospital, PL 52, 20521 Turku, Finland.
² Department of Orthopedics and Traumatology, Tampere University Hospital, PL 2000, 33521 Tampere, Finland.
³ Faculty of Sport and Health Sciences, University of Jyväskylä, PL 35, FI-40014 Jyväskylän yliopisto, Finland.
⁴ Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Hoitajantie 3, 40620 Jyväskylä, Finland.
⁵ Department of Obstetrics and Gynecology and Pelvic Floor Research and Therapy Unit, Central Finland Health Care Center, Hoitajantie 3, 40620 Jyväskylä, Finland.

Abstract

Introduction: Urinary incontinence (UI) during pregnancy is a common health problem. Vaginal delivery in particular affects the pelvic floor and increases the risk of pelvic floor dysfunctions. This prospective cohort study was conducted to investigate the incidence of UI during pregnancy and three months postpartum and determine the risk factors underlying UI.

Methods: In total, 547 volunteer women were recruited from the maternity clinic of a tertiary hospital. The participants filled out a questionnaire twice, one in the second trimester and the other three months after delivery. A multivariate logistic regression model with forward stepwise selection was used to analyze known risk factors for UI.

Results: The prevalence of UI during pregnancy was 39.5% and three months after childbirth 16.1%. Twenty-two percent of participants had pre-existing UI compared to 41.0% of the 88 women with UI three months postpartum. UI before pregnancy (OR 2.2), during pregnancy (OR 3.8) and primiparity (OR 2.3) were significantly associated with postpartum UI.

Conclusions: Women with UI before or during pregnancy and who are primiparous are at increased risk for postpartum UI. To prevent and reduce the risk factors contributing to UI, pregnant women should be routinely counseled.

Keywords: PFMT, pelvic floor muscle training; Pregnancy; Primiparity; UI, Urinary incontinence; Urinary incontinence.