Delivery parameters, neonatal parameters and incidence of urinary incontinence six months postpartum: a cohort study

作者：Wesnes Stian Langeland^*; Hannestad Yngvild; Rortveit Guri

来源：Acta Obstetricia et Gynecologica Scandinavica, 2017, 96(10): 1214-1222.

DOI：10.1111/aogs.13183

• Birthweight
• cohort study
• delivery analysis
• pregnancy
• urinary incontinence

IntroductionContradictory results have been reported regarding most delivery parameters as risk factors for urinary incontinence. We investigated the association between the incidence of urinary incontinence six months postpartum and single obstetric risk factors as well as combinations of risk factors.
Material and methodsThis study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health during 1998-2008. This substudy was based on 7561 primiparous women who were continent before and during pregnancy. Data were obtained from questionnaires answered at weeks 15 and 30 of pregnancy and six months postpartum. Data were linked to the Medical Birth Registry of Norway. Single and combined delivery- and neonatal parameters were analyzed by logistic regression analyses.
ResultsBirthweight was associated with significantly higher risk of urinary incontinence six months postpartum [3541-4180 g: odds ratio (OR) 1.4, 95% confidence interval (CI) 1.2-1.6; >4180 g: OR 1.6, 95% CI 1.2-2.0]. Fetal presentation, obstetric anal sphincter injuries, episiotomy and epidural analgesia were not significantly associated with increased risk of urinary incontinence. The following combinations of risk factors among women delivering by spontaneous vaginal delivery increased the risk of urinary incontinence six months postpartum; birthweight 3540 g and 36 cm head circumference; birthweight 3540 g and forceps, birthweight 3540 g and episiotomy; and 36 cm head circumference and episiotomy.
ConclusionSome combinations of delivery parameters and neonatal parameters seem to act together and may increase the risk of incidence of urinary incontinence six months postpartum in a synergetic way.

• 出版日期2017-10