Peripartum urinary incontinence in a racially diverse obstetrical population

Abstract

To determine the rates of urinary incontinence in a racially diverse, tertiary care obstetrical population during the third trimester and postpartum using a validated symptom-screening questionnaire. Third trimester prenatal patients receiving obstetric care at Loyola University Medical Center between March and November 2003 participated in this prospective study approved by the Institutional Review Board. Third-trimester participants completed the 15-item, validated Medical, Epidemiological, and Social Aspects of Aging (MESA) questionnaire and the Hunskaar Severity Index. The MESA was readministered to participants during a 6- to 8-week postpartum visit. One hundred and thirteen women completed antenatal and postpartum MESAs. Seventy-four percent (83 of 113) of the patients in the third trimester were categorized as incontinent. The postpartum incontinence rates decreased to 44% (50 of 113). Twenty-one percent (24 of 113) of the participants after delivery reported pure stress incontinence, 3% (3 of 113) urge incontinence, and 20% (23 of 113) mixed incontinence. Only 4% (5 of 113) of the women developed de novo incontinence postpartum: three reported symptoms of pure stress incontinence and two reported symptoms consistent with urge incontinence. The MESA questionnaire identifies more women with antenatal and postpartum urinary incontinence than currently described in the literature.

Prevalência de incontinência urinária autorreferida no pós-parto e fatores relacionados

“…These results confirmed those obtained in a study conducted in the U.S.A in 2003, which showed no statistically significant difference between continent and incontinent women concerning their mode of delivery (18) . In this regard, this study, showed that UI, in the postpartum, do not depend on the mode of delivery.…”

“…These results are in agreement with a study done in the U.S.A, in which it was found a prevalence of 46% and 43% respectively (18) , however, it contradicts those other studies conducted in Europe and in Brazil which found higher incidence of UI in multiparous than in primiparous (8,12,19,20) . The analysis of presented studies have shown that parturitions is a determinant risk factor to urinary incontinence in the postpartum.…”

Incontinência urinária autorreferida no pós-parto: características clínicas

“…Studies performed in Denmark and Spain (4,10) found a high association rate between UI in the postpartum and the type of childbirth and with the occurrence of UI during pregnancy. Similarly, a United States study (11) performed with 80 pregnant women with UI found that 44% of the participants continued incontinent after childbirth.…”

“…This location was chosen because it offers the chance to be in touch with women who were within six months of the postpartum period. The decision for conducting the interview between 30 days and six months postpartum was based on the fact that literature studies have been performed considering periods within this time interval (10)(11) .…”

“…The present study addressed UI in the postpartum period, as there is scarce national literature regarding this morbidity in this phase of the pregnancypuerperium cycle. In literature, studies state that urinary incontinence affect up to 74% of the formerly continent pregnant women (10)(11)(12) . Considering a population of age between 17 and 45 years, studies show UI prevalence in the postpartum between 20% and 27.5% (10,(12)(13)(14)(15) .…”