Aims
The aim of this study was to investigate constitutional‐, pregnancy‐, labor‐, and delivery‐related factors involved in the long‐term persistence of stress urinary incontinence (SUI) from 6 months postpartum to 12 years after first delivery. We also evaluated severity and impact on quality of life of persistent SUI.
Methods
This was a longitudinal study including primigravid women who gave birth at our Public Health Hospital during 2007. Urinary symptoms were investigated at inclusion, 6 months and 12 years after delivery. Persistent SUI was defined as SUI reported both at 6 months postpartum and 12 years after first delivery. The International Consultation on Incontinence‐Urinary Incontinence‐Short Form (ICIQ‐UI‐SF) and the Incontinence Severity Index (ISI) were used to evaluate SUI.
Results
During the inclusion period, 479 pregnant women were interviewed, 381 attended the 6‐month follow‐up visit, and 315 formed the study group. SUI persisted in 36 out of 44 (81.8%) women. With the ISI, 52.8% of these women were categorized as having slight, 41.7% moderate, and 5.6% severe incontinence. The mean ICIQ‐UI‐SF score was 7.13 (SD 3.51). Pregnancy SUI (odds ratio [OR], 4.54; 95% confidence interval [CI], 2.10‐9.80) and active second stage of labor more than or equal to 1 hour (OR, 3.68; 95% CI, 1.21‐11.14) were independently associated with persistent SUI.
Conclusions
Women who reported SUI during pregnancy, and those who had pushed for more than or equal to 1 hour in the second stage of labor were at greater risk of SUI persisting from 6 months postpartum to long after delivery. We found this independent association after controlling for several constitutional‐, pregnancy‐, labor‐, and delivery‐related variables.
To assess a screening program for sexually transmitted infections (STIs) in under-30-year-old pregnant women, focusing on Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium infections, which though often asymptomatic, may significantly affect women's health and can be vertically transmitted. Design: Prospective, descriptive, observational study. Setting: Gipuzkoa (Basque Country, Spain). Population: Under-30-year-old pregnant women. Methods: Between 2016 and 2020, cervical samples were taken at first prenatal appointments from 3051 women. STIs were detected by multiplex nucleic acid amplification. Main Outcome Measures: Prevalence of infections by age and geographical origin groups, and screening coverage. Results: The coverage rate was 86% between 2017 and 2020. At least one STI was detected in 5.2% of the under-30-year-olds screened (95% confidence interval [CI]: 4.5%, 6.1%): C. trachomatis in 4%, M. genitalium in 1.3% and N. gonorrhoeae in 0.1%. C. trachomatis and M. genitalium prevalence rates were higher among younger women (7.2% and 2.8%, respectively in under-25-year-olds), while C. trachomatis prevalence in 25-to 30-year-olds was 2.5%. C. trachomatis was more common among Latin American women (9.7% [95% CI: 7.4%, 12.3%] vs. 2.5% [95% CI: 2.0%, 3.2%] in other women). Additionally, analysing samples from 708 pregnant over-30-year-old women with STI risk factors, 1.6% had at least one of the STIs studied. Notably, 20% of all cases had STI-related symptoms or complications during pregnancy. Conclusions: The high coverage achieved, and prevalence, clinical and epidemiological results support the view that the implementation of a screening program across Spain for C. trachomatis in under-30-year-old pregnant women would be both feasible and appropriate.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.