PDF herunterladen
CC BY 4.0 · Rev Bras Ginecol Obstet 2020; 42(12): 787-792
DOI: 10.1055/s-0040-1718951
Original Article
Obstetrics

Risk Factors for Urinary Incontinence in Pregnancy: A Case Control Study

Fatores de risco para incontinência urinária na gravidez: Um estudo de caso controle
Fernanda Borsatto Caruso 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Lucas Schreiner 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Alexandra Damasio Todescatto 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Isabel Crivelatti 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
,
Julia Monteiro de Oliveira 
1   Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
› Institutsangaben Funding This study was conducted with support from the Brazilian National Council for Scientific and Technological Development (CNPq, in the Portuguese acronym) and the Coordination for the Improvement of Higher Education Personnel (CAPES, in the Portuguese acronym).
› Weitere Informationen
   Lizenzen und Reprints

Abstract

Objective 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.

Methods 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.

Results 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.

Conclusion 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.

Resumo

Objetivo A incontinência urinária (IU) é um importante problema de saúde pública que pode trazer prejuízos às mulheres em qualquer período da vida, inclusive durante o período gestacional. A IU durante a gravidez tem sido estudada por ser capaz de reduzir a qualidade de vida e interferir em vários aspectos do binômio materno-fetal. O objetivo deste estudo foi determinar a prevalência de IU em gestantes nulíparas e identificar fatores de risco associados a essa população.

Métodos Este é um estudo de caso-controle em que foram convidadas mulheres nulíparas entre 12 e 20 semanas de gravidez para participar do projeto. Elas foram submetidas a um questionário específico, diário miccional de 3 dias e avaliação uroginecológica, incluindo quantificação de prolapso de órgãos pélvicos (POP-Q), teste de esforço com volume residual e avaliação da musculatura do assoalho pélvico.

Resultados Um total de 70 das 73 pacientes aceitaram participar do estudo, e a prevalência de incontinência urinária nessa população foi de 18,3%. O uso de tabaco foi identificado como fator de risco independente para a IU em gestantes (OR 8,0). Todos os outros fatores analisados não foram significativamente associados à perda urinária nessa população.

Conclusão A incontinência urinária pode trazer prejuízos para pacientes durante o período da gestação. O tabagismo foi identificado como fator de risco para o desenvolvimento de IU em gestantes, o que denota mais um motivo para encorajar as pacientes a abandonarem o hábito.

Keywords

urinary incontinence - pregnancy - pelvic floor - tobacco use

Palavras-chave

incontinência urinária - gestação - assoalho pélvico - tabagismo

Contributors

All of the authors participated in the concept and design of the present study; analysis and interpretation of data; drafting or revision of the manuscript, and they have approved the manuscript as submitted. All authors are responsible for the reported research.




Publikationsverlauf

Eingereicht: 05. April 2020

Angenommen: 10. August 2020

Artikel online veröffentlicht:
21. Dezember 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Sangsawang B. Risk factors for the development of stress urinary incontinence during pregnancy in primigravidae: a review of the literature. Eur J Obstet Gynecol Reprod Biol 2014; 178: 27-34 DOI: 10.1016/j.ejogrb.2014.04.010.
    CrossrefPubMedGoogle Scholar
  • 2 Sangsawang B, Sangsawang N. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J Pelvic Floor Dysfunct 2013; 24 (06) 901-912 DOI: 10.1007/s00192-013-2061-7.
    CrossrefPubMedGoogle Scholar
  • 3 Liang CC, Chang SD, Lin SJ, Lin YJ. Lower urinary tract symptoms in primiparous women before and during pregnancy. Arch Gynecol Obstet 2012; 285 (05) 1205-1210 DOI: 10.1007/s00404-011-2124-2.
    CrossrefPubMedGoogle Scholar
  • 4 Fritel X, Fauconnier A, Bader G, Cosson M, Debodinance P, Deffieux X. et al; French College of Gynaecologists and Obstetricians. Diagnosis and management of adult female stress urinary incontinence: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. Eur J Obstet Gynecol Reprod Biol 2010; 151 (01) 14-19 DOI: 10.1016/j.ejogrb.2010.02.041.
    CrossrefPubMedGoogle Scholar
  • 5 Mørkved S, Salvesen KA, Bø K, Eik-Nes S. Pelvic floor muscle strength and thickness in continent and incontinent nulliparous pregnant women. Int Urogynecol J Pelvic Floor Dysfunct 2004; 15 (06) 384-389, discussion 390 DOI: 10.1007/s00192-004-1194-0.
    CrossrefPubMedGoogle Scholar
  • 6 Stafne SN, Salvesen KA, Romundstad PR, Torjusen IH, Mørkved S. Does regular exercise including pelvic floor muscle training prevent urinary and anal incontinence during pregnancy? A randomised controlled trial. BJOG 2012; 119 (10) 1270-1280 DOI: 10.1111/j.1471-0528.2012.03426.x.
    CrossrefPubMedGoogle Scholar
  • 7 Pelaez M, Gonzalez-Cerron S, Montejo R, Barakat R. Pelvic floor muscle training included in a pregnancy exercise program is effective in primary prevention of urinary incontinence: a randomized controlled trial. Neurourol Urodyn 2014; 33 (01) 67-71 DOI: 10.1002/nau.22381.
    CrossrefPubMedGoogle Scholar
  • 8 Tähtinen RM, Cartwright R, Tsui JF, Aaltonen RL, Aoki Y, Cárdenas JL. et al. Long-term impact of mode of delivery on stress urinary incontinence and urgency urinary incontinence: a systematic review and meta-analysis. Eur Urol 2016; 70 (01) 148-158 DOI: 10.1016/j.eururo.2016.01.037.
    CrossrefPubMedGoogle Scholar
  • 9 Zhou HH, Shu B, Liu TZ, Wang XH, Yang ZH, Guo YL. Association between parity and the risk for urinary incontinence in women: A meta-analysis of case-control and cohort studies. Medicine (Baltimore) 2018; 97 (28) e11443 DOI: 10.1097/MD.0000000000011443.
    CrossrefPubMedGoogle Scholar
  • 10 Beksac AT, Aydin E, Orhan C, Karaagaoglu E, Akbayrak T. Gestational urinary incontinence in nulliparous pregnancy - a pilot study. J Clin Diagn Res 2017; 11 (08) QC01-QC03 DOI: 10.7860/JCDR/2017/25572.10333.
    CrossrefPubMedGoogle Scholar
  • 11 Mason L, Glenn S, Walton I, Appleton C. The prevalence of stress incontinence during pregnancy and following delivery. Midwifery 1999; 15 (02) 120-128 DOI: 10.1016/s0266-6138(99)90008-6.
    CrossrefPubMedGoogle Scholar
  • 12 Sharma JB, Aggarwal S, Singhal S, Kumar S, Roy KK. Prevalence of urinary incontinence and other urological problems during pregnancy: a questionnaire based study. Arch Gynecol Obstet 2009; 279 (06) 845-851 DOI: 10.1007/s00404-008-0831-0.
    CrossrefPubMedGoogle Scholar
  • 13 Zhu L, Li L, Lang JH, Xu T. Prevalence and risk factors for peri- and postpartum urinary incontinence in primiparous women in China: a prospective longitudinal study. Int Urogynecol J Pelvic Floor Dysfunct 2012; 23 (05) 563-572 DOI: 10.1007/s00192-011-1640-8.
    CrossrefPubMedGoogle Scholar
  • 14 Hvidman L, Hvidman L, Foldspang A, Mommsen S, Bugge Nielsen J. Correlates of urinary incontinence in pregnancy. Int Urogynecol J Pelvic Floor Dysfunct 2002; 13 (05) 278-283 DOI: 10.1007/s001920200061.
    CrossrefPubMedGoogle Scholar
  • 15 Quiroz L, Rostaminia G, Pickett SD, Peck J, Stone DE, Shobeiri S. The association between risk of levator ani damage and age in primiparous women. Female Pelvic Med Reconstr Surg 2016; 22 (05) S13
    PubMedGoogle Scholar
  • 16 Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG 2003; 110 (03) 247-254 DOI: 10.1046/j.1471-0528.2003.02327.x.
    CrossrefPubMedGoogle Scholar
  • 17 Lifford KL, Curhan GC, Hu FB, Barbieri RL, Grodstein F. Type 2 diabetes mellitus and risk of developing urinary incontinence. J Am Geriatr Soc 2005; 53 (11) 1851-1857 DOI: 10.1111/j.1532-5415.2005.53565.x.
    CrossrefPubMedGoogle Scholar
  • 18 Saydah SH, Chandra A, Eberhardt MS. Pregnancy experience among women with and without gestational diabetes in the U.S., 1995 National Survey Of Family Growth. Diabetes Care 2005; 28 (05) 1035-1040 DOI: 10.2337/diacare.28.5.1035.
    CrossrefPubMedGoogle Scholar
  • 19 Jain P, Parsons M. The effects of obesity on the pelvic floor. Obstet Gynaecol 2011; 13 (03) 133-142 DOI: 10.1576/toag.13.3.133.27664.
    CrossrefPubMedGoogle Scholar
  • 20 Bump RC, Sugerman HJ, Fantl JA, McClish DK. Obesity and lower urinary tract function in women: effect of surgically induced weight loss. Am J Obstet Gynecol 1992; 167 (02) 392-397, discussion 397–399 DOI: 10.1016/s0002-9378(11)91418-5.
    CrossrefPubMedGoogle Scholar
  • 21 Eltatawy HH, Elhawary TM, Soliman MG, Taha MR. The link between female obesity and urinary stress incontinence. UroToday Int J. 2011; 4 (05) 63 DOI: 10.3834/uij.1944-5784.2011.10.05.
    CrossrefPubMedGoogle Scholar
  • 22 Ozerdoğan N, Beji NK, Yalçin O. Urinary incontinence: its prevalence, risk factors and effects on the quality of life of women living in a region of Turkey. Gynecol Obstet Invest 2004; 58 (03) 145-150 DOI: 10.1159/000079422.
    CrossrefPubMedGoogle Scholar
  • 23 Tingthong W, Buppasiri P, Chongsomchai C, Temtanakitpaisan T, Sangkomkamhang U. Prevalence of urinary incontinence in pregnant women at 37 Tertiary Care Hospitals in KhonKaen Province. Thai J Obstet Gynaecol. 2014; 22 (01) 37-43
    PubMedGoogle Scholar
  • 24 Hansen BB, Svare J, Viktrup L, Jørgensen T, Lose G. Urinary incontinence during pregnancy and 1 year after delivery in primiparous women compared with a control group of nulliparous women. Neurourol Urodyn 2012; 31 (04) 475-480 DOI: 10.1002/nau.21221.
    CrossrefPubMedGoogle Scholar
  • 25 Botlero R, Urquhart DM, Davis SR, Bell RJ. Prevalence and incidence of urinary incontinence in women: review of the literature and investigation of methodological issues. Int J Urol 2008; 15 (03) 230-234 DOI: 10.1111/j.1442-2042.2007.01976.x.
    CrossrefPubMedGoogle Scholar