Risk Factors for Postpartum Stress Urinary Incontinence: a Systematic Review and Meta-analysis
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REVIEW
Risk Factors for Postpartum Stress Urinary Incontinence: a Systematic Review and Meta-analysis Kai Wang 2 & Xianlin Xu 2 & Genmei Jia 1 & Hua Jiang 1 Received: 14 April 2020 / Revised: 5 June 2020 / Accepted: 30 June 2020 # Society for Reproductive Investigation 2020
Abstract Stress urinary incontinence (SUI) is a distressing symptom affecting females globally and is one of the most common complications of delivery. The etiology of female SUI is multifactorial, and the trauma caused by delivery is one of the most important risk factors for SUI. We performed a meta-analysis to determine the relationship between these various factors and postpartum SUI. We searched PubMed, Embase, Web of Science, and the Cochrane Library until January 2019 using appropriate keywords and extracted 46 eligible studies that included 73,010 participants. The study protocol was registered with PROSPERO (No. CRD42020150094). The pooled results indicated that 12 risk factors, including vaginal delivery (OR 2.08, 95% CI 1.72–2.52), advanced age at gestation (OR 1.06, 95% CI 1.04–1.08), advanced maternal BMI (OR 1.04, 95% CI 1.03–1.06), excess weight gain during pregnancy (OR 1.13, 95% CI 1.00–1.26), advanced current BMI (OR 1.32, 95% CI 1.02–1.70), diabetes (OR 1.91, 95% CI 1.53–2.38), episiotomy (OR 1.76, 95% CI 1.06–2.94), forceps delivery (OR 2.69, 95% CI 1.25–5.76), gestational UI (OR 5.04, 95% CI 2.07–12.28), gestational SUI (OR 4.28, 95% CI 2.61–7.01), prenatal UI (OR 8.54, 95% CI 3.52–20.70), and early postpartum UI (OR 3.52, 95% CI 1.61–7.69), were associated with postpartum SUI. The findings of this analysis could serve to generate risk prediction models and provide a basis for developing treatment strategies for patients with postpartum SUI. Keywords Meta-analysis . Postpartum stress urinary incontinence . Pregnancy . Review . Risk factor
Abbreviations SUI Stress urinary incontinence UI Urinary incontinence UUI Urge urinary incontinence OR Odds ratio RR Relative risk HR Hazard ratio CI Confidence interval BMI Body mass index OASIS Obstetrical anal sphincter injuries
* Hua Jiang [email protected] 1
Department of Gynecology and Obstetrics, Women’s Hospital of Nanjing Medical University Nanjing Maternity and Child Health Care Hospital Tianfei Alley, Mochou Road, Nanjing 210004, Jiangsu Province, China
2
Department of Urology, Sir Run Run Hospital Nanjing Medical University, Nanjing 211100, Jiangsu Province, China
Introduction Urinary incontinence (UI) is a health issue associated with negative quality of life in females globally and is one of the most common complications of delivery. Stress urinary incontinence (SUI) accounts for most types of UI cases [1]. The etiology of female SUI is multifactorial, and the trauma caused by delivery is one of the most important risk factors for SUI. Many women with SUI cannot recover during the postpartum period and eventually develop persistent UI [2–4]. SUI can be accompanied by other forms of involuntary urine leakage, including urge urinary incontinence (UUI) in 36% of those
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