Factors involved in the persistence of stress urinary incontinence from postpartum to 12 years after first delivery

• Published in: Neurourology and urodynamics 2020-08, Vol.39 (6), p.1849-1855
• Main Authors: Diez‐Itza, Irene, Zubikarai, Maitane, Galan, Claudia, Ginto, Leire, Saro, Javier, Arrue, Miren
• Format: Article
• Language: English
• Subjects: Adult; delivery; Female; Humans; labor; Longitudinal Studies; parity; Postpartum; Postpartum Period; Pregnancy; Public health; Quality of Life; Risk Factors; stress urinary incontinence; Urinary incontinence; Urinary Incontinence, Stress - physiopathology; Urinary Incontinence, Stress - psychology
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.24442

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.