Prevalence and risk factors of persistent stress urinary incontinence at three months postpartum in Indonesian women
Abstract: Mode of delivery and
some certain risk factors have a relationship to postpartum stress urinary
incontinence (SUI). For that reason, the objective of this study was to assess
the prevalence of postpartum stress urinary incontinence (SUI), the
relationship between postpartum SUI and mode of delivery; and the association
between SUI and other demographic and obstetric factors.
Methods: In this prospective observational cohort study, all primiparous
women who were under postpartum care in obstetric and gynecologic ward were
recruited. Four hundreds primiparous women with no history of urinary incontinence
(UI) who fulfilled the criteria and would like to participate in this study
were followed up for three months after delivery. The analysis was done using
Stata 12. Bivariate analysis using Chi-square test and multivariate analysis
using logistic regression test were done to obtain associated risk factors to
postpartum SUI.
Results: The prevalence of postpartum SUI was 8.8%. The mode of delivery
was significantly associated with postpartum SUI, there were more women who got
vaginal delivery that had stress urinary incontinence (14.1%) compared to women
caesarean section (7.1%) with OR=2.1 (95% CI=1.05-4.31), this risk increased
when vaginal delivery was assisted with vacuum instrument (OR=9.1, 95%
CI=3.9-21.6). There was no statistical difference of stress urinary
incontinence incidences in patients with emergency or elective caesarean
section with OR=0.84 (95% CI=0.28-2.57). Based on multivariate analysis BMI ≥30
kg/m2 at labor, vacuum assisted delivery, birth weight more than 3,360 g, and
second stage labor more than 60 minutes appeared to be associated with an
increased rate of postpartum SUI.
Conclusion: Stress urinary incontinence increased in the early postpartum
period of a primiparous woman. Although vaginal delivery increased the risk of
postpartum SUI, elective nor emergency caesarean delivery without vaginal
delivery id not appear to increase the risk of stress urinary incontinence.
Author: Edy Fakhrizal, Tyas
Priyatini, Budi I. Santoso, Junizaf Junizaf, Fernandi Moegni, Suskhan Djusad,
Surahman Hakim, Sri W. Maryuni
Journal Code: jpkedokterangg160153
