Barbosa Leila, Boaviagem Alessandra, Moretti Eduarda, Lemos Andrea
Physical Therapy Department, Universidade Federal de Pernambuco (UFPE), Av Prof. Moraes Rego, 1235 Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil.
Int Urogynecol J. 2018 Oct;29(10):1413-1427. doi: 10.1007/s00192-018-3656-9. Epub 2018 May 12.
Multiparity, age and high body mass index (BMI) are the most widely investigated factors associated with urinary incontinence (UI) during pregnancy. We hypothesized that multiparity, age 35 years or older and high BMI (prepregnancy and during pregnancy) are risk factors for the occurrence of UI in pregnant women.
Searches were done on MEDLINE/PubMed (1966-2017), LILACS/BIREME (1982-2017), CINAHL/Ebsco (1981-2017) and Scopus/Elsevier (1950-2017). The following criteria were used for study eligibility: (1) population: low-risk pregnant women in any trimester and without age restriction; (2) exposure factors: multiparity (≥ 2 deliveries), age 35 years or older and high BMI (overweight and obesity); (3) outcome: UI during pregnancy; (4) study design: cohort, case-control or cross-sectional studies that used multivariate logistic analysis. Two independent reviewers performed the entire systematic review process. Data extraction of each article was done and, when possible, included in a meta-analysis. Risk of study bias was assessed by NOS and quality of evidence by GRADE. A significance level of p ≤ 0.05 was adopted. The PROSPERO registration number was CRD42014013193.
Of 1176 articles identified through searches, 13 were included after screening and application of eligibility criteria. Very low quality of evidence shows that multiparity (OR = 2.09; 95% CI: 1.07 to 4.08), age 35 years or older (OR = 1.53; 95% CI: 1.45 to 1.62) and overweight and obesity during pregnancy (OR = 1.53; 95% CI: 1.28 to 1.83) are risk factors for UI in pregnancy.
The exposure factors investigated are risk factors for UI in pregnancy based on a very low quality of evidence.
多产、年龄及高体重指数（BMI）是孕期尿失禁（UI）研究最为广泛的相关因素。我们假设多产、35岁及以上年龄以及高BMI（孕前及孕期）是孕妇发生UI的危险因素。
检索MEDLINE/PubMed（1966 - 2017年）、LILACS/BIREME（1982 - 2017年）、CINAHL/Ebsco（1981 - 2017年）和Scopus/Elsevier（1950 - 2017年）数据库。研究纳入标准如下：（1）研究对象：各孕周的低风险孕妇，无年龄限制；（2）暴露因素：多产（≥2次分娩）、35岁及以上年龄以及高BMI（超重和肥胖）；（3）结局指标：孕期UI；（4）研究设计：采用多因素逻辑分析的队列研究、病例对照研究或横断面研究。由两名独立的评审员完成整个系统评价过程。对每篇文章进行数据提取，并在可能的情况下纳入荟萃分析。采用NOS评估研究偏倚风险，采用GRADE评估证据质量。采用p≤0.05的显著性水平。PROSPERO注册号为CRD42014013193。
通过检索确定的1176篇文章中，经筛选和应用纳入标准后，有13篇被纳入。证据质量极低表明，多产（OR = 2.09；95%CI：1.07至4.08）、35岁及以上年龄（OR = 1.53；95%CI：1.45至1.62）以及孕期超重和肥胖（OR = 1.53；95%CI：1.28至1.83）是孕期UI的危险因素。
基于极低的证据质量，所研究的暴露因素是孕期UI的危险因素。
