Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld 4131, Australia; Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Qld 4215, Australia.
Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld 4131, Australia.
Midwifery. 2020 Apr;83:102628. doi: 10.1016/j.midw.2020.102628. Epub 2020 Jan 14.
To evaluate a framework to facilitate standardised reporting of perinatal incontinence.
An exploratory, prospective, observational cohort study.
One Australian tertiary maternity referral centre.
Data from 309 pregnant women collected between August 2017 and January 2019.
A framework was developed using consensus-based terminology and definitions, measures and data-collection time-points. The ICIQ-UI SF and the Wexner Scale were administered during pregnancy (<27 and 36-weeks) and postpartum (6- and 26-weeks). Incidence, trajectory and group differences for urinary incontinence subcategories were evaluated. Stress urinary incontinence was the largest contributor of urinary incontinence during pregnancy (39.2%) followed by mixed (11.3%) and urgency incontinence (7.4%). Factors associated with incontinence subcategories during pregnancy were multiparity (stress: RR 1.74), co-existing anal incontinence (mixed: RR 3.51) and early pregnancy urinary incontinence (stress: RR 2.79; mixed: RR 2.85). Factors postpartum included primiparity (urgency), vaginal birth (stress), induction of labour (stress: RR 2.99; urgency: RR 0.2), waterbirth (urgency: RR 2.66), coexisting anal incontinence (urgency: RR 3.55) and late pregnancy urinary incontinence (mixed: RR 3.97). Low numbers of women with anal incontinence prohibited subcategory analysis.
Findings offer preliminary support for the effectiveness of the framework for the measurement and reporting of urinary incontinence in childbearing women. Future research is needed to evaluate the framework in larger and more diverse maternity populations.
A framework for standardised measurement and reporting of perinatal incontinence will facilitate improved synthesis of research findings with the potential to improve the quality of evidence-based clinical guidelines.
评估便于围产期尿失禁标准化报告的框架。
探索性、前瞻性、观察性队列研究。
澳大利亚一家三级产科转诊中心。
2017 年 8 月至 2019 年 1 月期间收集的 309 名孕妇的数据。
使用基于共识的术语和定义、措施和数据收集时间点制定了一个框架。在妊娠期间（<27 和 36 周）和产后（6 周和 26 周）进行了 ICIQ-UI SF 和 Wexner 量表评估。评估了尿失禁亚类别的发生率、轨迹和组间差异。妊娠期间尿失禁最大的亚类是压力性尿失禁（39.2%），其次是混合性（11.3%）和急迫性尿失禁（7.4%）。与妊娠期间尿失禁亚类相关的因素包括多胎妊娠（压力：RR 1.74）、并存的肛门失禁（混合：RR 3.51）和妊娠早期尿失禁（压力：RR 2.79；混合：RR 2.85）。产后的因素包括初产妇（急迫性）、阴道分娩（压力）、引产（压力：RR 2.99；急迫性：RR 0.2）、水中分娩（急迫性：RR 2.66）、并存的肛门失禁（急迫性：RR 3.55）和妊娠晚期尿失禁（混合：RR 3.97）。肛门失禁的女性数量较少，无法进行亚类分析。
研究结果初步支持该框架用于测量和报告分娩期妇女尿失禁的有效性。需要进一步的研究来评估该框架在更大和更多样化的产妇人群中的效果。
围产期尿失禁标准化测量和报告的框架将有助于改善研究结果的综合，有可能提高循证临床指南的质量。
