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Published in: International Urogynecology Journal 7/2016

01-07-2016 | Original Article

Is prenatal urethral descent a risk factor for urinary incontinence during pregnancy and the postpartum period?

Authors: Anne-Cécile Pizzoferrato, Arnaud Fauconnier, Georges Bader, Renaud de Tayrac, Julie Fort, Xavier Fritel

Published in: International Urogynecology Journal | Issue 7/2016

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Abstract

Introduction and hypothesis

Obstetric trauma during childbirth is considered a major risk factor for postpartum urinary incontinence (UI), particularly stress urinary incontinence. Our aim was to investigate the relation between postpartum UI, mode of delivery, and urethral descent, and to define a group of women who are particularly at risk of postnatal UI.

Methods

A total of 186 women were included their first pregnancy. Validated questionnaires about urinary symptoms during pregnancy, 2 and 12 months after delivery, were administered. Urethral descent was assessed clinically and by ultrasound at inclusion. Multivariate logistic regression analysis was used to determine the risk factors for UI during pregnancy, at 2 months and 1 year after first delivery.

Results

The prevalence of UI was 38.6, 46.5, 35.6, and 34.4 % at inclusion, late pregnancy, 2 months postpartum, and 1 year postpartum respectively. No significant association was found between UI at late pregnancy and urethral descent assessed clinically or by ultrasound. The only risk factor for UI at 2 months postpartum was UI at inclusion (OR 6.27 [95 % CI 2.70–14.6]). The risk factors for UI at 1 year postpartum were UI at inclusion (6.14 [2.22–16.9]), body mass index (BMI), and urethral descent at inclusion, assessed clinically (7.21 [2.20–23.7]) or by ultrasound. The mode of delivery was not associated with urethral descent.

Conclusions

Prenatal urethral descent and UI during pregnancy are risk factors for UI at 1 year postpartum. These results indicate that postnatal UI is more strongly influenced by susceptibility factors existing before first delivery than by the mode of delivery.
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Metadata
Title
Is prenatal urethral descent a risk factor for urinary incontinence during pregnancy and the postpartum period?
Authors
Anne-Cécile Pizzoferrato
Arnaud Fauconnier
Georges Bader
Renaud de Tayrac
Julie Fort
Xavier Fritel
Publication date
01-07-2016
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 7/2016
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-015-2918-z

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