Abstract
Urinary incontinence (UI) is a common condition that causes significant harm to the well-being and quality of life of pregnant women. This cross-sectional population-based study aimed to estimate the prevalence and identify factors associated with the occurrence of UI during pregnancy in women living in the municipality of Rio Grande (RS), Southern Brazil, between January 1 and December 31 of 2016, and included all puerperae living in this municipality that had a child in one of the two local maternity hospitals. The previously trained interviewers used a single standardized questionnaire, within 48 hours after delivery to retrieve information on maternal demographic, behavioral and reproductive/obstetric history, as well as socioeconomic status of the household and care received during pregnancy and childbirth. The multivariate analysis followed a previously defined hierarchical model using Poisson regression with robust variance adjustment and prevalence ratio (PR) as a measure of effect. As a result, 2,716 puerperae were identified, of which 2,694 (99.2%) participated in this study. The prevalence of urinary incontinence in the gestational period was 14.7% (95%CI: 13.4%-16.1%). After adjusted analysis, the likelihood of UI occurring varied significantly as per women's characteristics. For example, the PR for the occurrence of UI among women over 30 years of age was 2.05 (95% CI: 1.39-3.01) compared to adolescents. In two other groups of women who had their first pregnancy before the age of 20 or after the age of 30, the PR for UI was 1.36 (95% CI: 1.04-1.76) and 1.59 (95% CI: 1.01-2.51), respectively, when compared to those who became pregnant for the first time between 20 and 29 years of age. Finally, in two other groups of women, namely, those who reached 90 kg and over at the end of pregnancy and those who performed regular physical exercise and reported frequent urinary urgency, the PR was 2.49 (95% CI: 1.74-3.57), and 2.90 (95% CI: 2.10-4.00) compared to those who did not exercise and did not report urinary urgency, respectively. The authors concluded that UI showed a high prevalence in the study population. The identified risk factors can be well administered at primary health care level. The recommendation of regular physical exercise in pregnancy must be reviewed and better investigated with more robust designs because of possible facilitators for the occurrence of UI in this period.
Highlights
Urinary incontinence (UI) is defined as any involuntary loss of urine, and the prevalence increases with advancing age [1]
This study aims to measure the prevalence and to identify factors associated with the occurrence of UI in the gestational period among puerperae living in the municipality of Rio Grande (RS), Southern Brazil, during 2016
About 14.7% of women reported having urinary incontinence
Summary
Urinary incontinence (UI) is defined as any involuntary loss of urine, and the prevalence increases with advancing age [1]. Its occurrence ranges from 40% to 60% among women, and from 10% to 20% among men [2] This higher occurrence among women is generally due to their reproductive life [3]. Enlargement of the uterus, pelvic floor changes during gestation, and trauma suffered during delivery lead to involuntary loss of urine [4,5,6]. UI during gestation is a significant predictor for its presence in subsequent pregnancies and at a later age [7], which makes it a chronic disease with a substantial deterioration of the quality of life, whether due to discomfort, the need for regular personal hygiene, or insecurity, among others. UI leads to isolation, which favors depression and more severe psychiatric conditions [8,9]
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