Risk Factors for Urinary Incontinence in Primiparous Adolescents after Vaginal Delivery: A Cohort Study.

STUDY OBJECTIVE

To evaluate urinary incontinence (UI) risk factors in primiparous adolescents between 7 and 48 months after vaginal delivery.

DESIGN

Cohort study.

SETTING

Physical Therapy Laboratory on Women's Health and Pelvic Floor at the Federal University of Pernambuco.

PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Cohort follow-up time was 7-48 months after delivery, guaranteeing that no participant presented with UI until 7 months after the infant's birth. Primiparous adolescents aged 10-19 years were included in the study, and those who had UI during pregnancy were excluded. Sample size was estimated at 140 volunteers, considering the calculation for logistic regression, with 20 observation units for each of the 7 variables proposed in the theoretical model developed for the study. The volunteers answered the evaluation form, providing information on the outcome of interest and possible risk factors. Univariate logistic regression analysis was performed.

RESULTS

The following risk factors for UI were identified in primiparous adolescents after vaginal delivery: episiotomy (Relative risk [RR], 2.75; 95% confidence interval [CI], 1.22-6.06), large newborn for gestational age (RR, 4.58; 95% CI, 1.68-12.46) and less than six prenatal appointments (RR, 2.51; 95% CI, 1.05-6.04).

CONCLUSION

Professionals working in maternal health care should pay special attention to primigravid mothers, guide prenatal appointments, avoid routine episiotomy, and use obstetric practices recommended by the World Health Organization.