Abstract
Urinay incontinence (UI) is a major public health problem that can harm women in any period of life, including during the gestational period. Urinary incontinence during pregnancy has been studied because this condition can reduce the quality of life and interfere in several aspects of the maternal-fetal binomial. The aim of this study was to determine the prevalence of UI in nullipara pregnant women and to identify risk factors associated with UI in this population. This is a case-control study in which we invited nullipara women between 12 and 20 weeks of pregnancy to participate in the research. They were asked to answer a specific questionnaire, write a 3-day bladder diary, and undergo a urogynecological evaluation including pelvic organ prolapse quantification (POP-Q), empty stress supine test (ESST), and pelvic floor muscle assessment. A total of 70 out of 73 patients accepted to participate in the study, and the prevalence of UI in this population was 18.3%. Tobacco use was identified as an independent risk factor for UI in pregnant women (odds ratio 8.0). All other factors analyzed were not significantly associated to UI in pregnancy. Urinary incontinence can be a major problem in pregnancy. We identified the use of tobacco as a risk factor for developing UI in pregnancy, which provides an extra reason to encourage patients to quit smoking.
Highlights
Pregnancy is one of the main risk factors for the development of urinary incontinence (UI) in young women
We identified the use of tobacco as a risk factor for developing UI in pregnancy, which provides an extra reason to encourage patients to quit smoking
Smoking was the only risk factor with statistical significance for UI in pregnancy, 57.1% of UI in smokers versus 14.3% in non-smokers OR 8.0. (►Table 3).Among the incontinent patients, 76.9% complained of stress urinary incontinence (SUI) and 53.8% of urgency When we calculated the patients’ body mass index (BMI), we found a higher mean BMI in incontinent patients (33.3 kg/m2 incontinent vs 29.5 kg/m2 in the continents), but the difference was not statistically significant in the sample
Summary
Pregnancy is one of the main risk factors for the development of urinary incontinence (UI) in young women. Physiological changes during pregnancy, such as increasing pressure of the growing uterus and fetal weight on the pelvic floor muscle (PFM) throughout pregnancy, together with pregnancy-related hormonal changes such as increased progesterone, decreased relaxin, and decreased collagen levels, may lead to reduced strength and supportive and sphincteric function of the PFM. Pregnancy may associate with the reduction of the PFM strength, which can lead to stress urinary incontinence (SUI).[1]. Studies in pregnant women with SUI have found significantly decreased PFM strength in incontinent pregnant women as compared with continent pregnant women.[5]. Women with moderate-to-severe UI may suffer from emotional disorders, social embarrassment, loss of self-esteem, and have sexual relationship difficulties, since many present loss of urine during the sexual act.[6,7]
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