Department of Midwifery, Marand Branch, Islamic Azad University, Marand, Iran.
Reproductive Health Promotion Research Center, Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Int Urogynecol J. 2020 Nov;31(11):2205-2224. doi: 10.1007/s00192-020-04442-x. Epub 2020 Jul 25.
Urinary incontinence (UI) is one of the most serious problems during pregnancy and after delivery. It can influence the quality of life and cause psychological problems that lead to depression and decreased self-esteem. We aimed to investigate the maternal, obstetrical and neonatal risk factors of urinary incontinence 3 to 12 months after childbirth.
The Cochrane Library, Medline, Science Direct and Web of Science were searched for studies published from the inception of the databases up to December 2019, including any observational full-text papers. All data were analyzed using Review Manager 5.3. Of 338 articles reviewed, 20 studies were considered for meta-analysis.
The results of our study showed that vaginal delivery in contrast to cesarean section (OR = 3.74, 95% CI: [2.71, 5.15], P < 0.00001), UI in pregnancy (OR = 5.27, 95% CI: [3.40, 8.17], P < 0.00001), episiotomy (OR = 1.23, 95% CI: [1.05, 1.45], P < 0.01), perineal tear > grade 2, instrumental delivery in contrast to cesarean section, epidural or spinal anesthesia, maternal age, pre-pregnancy BMI and neonatal birthweight have a direct relationship with UI.
This study confirmed that urinary incontinence during pregnancy and vaginal births had the strongest relationship with postpartum urinary incontinence. Also, the maternal upright positions during labor did not reduce the likelihood of urinary incontinence. The awareness of this issue helps find effective strategies to reduce the likelihood of female urinary incontinence.
尿失禁（UI）是妊娠和分娩后最严重的问题之一。它会影响生活质量，并导致心理问题，从而导致抑郁和自尊心下降。我们旨在调查产后 3 至 12 个月尿失禁的产妇、产科和新生儿危险因素。
从数据库开始到 2019 年 12 月，我们检索了 Cochrane 图书馆、Medline、Science Direct 和 Web of Science 中的研究，包括任何观察性全文论文。使用 Review Manager 5.3 分析所有数据。在审查的 338 篇文章中，有 20 项研究进行了荟萃分析。
我们的研究结果表明，与剖宫产相比，阴道分娩（OR=3.74，95%CI：[2.71,5.15]，P<0.00001）、妊娠时尿失禁（OR=5.27，95%CI：[3.40,8.17]，P<0.00001）、会阴切开术（OR=1.23，95%CI：[1.05,1.45]，P<0.01）、会阴裂伤>2 级、器械分娩与剖宫产、硬膜外或脊髓麻醉、产妇年龄、孕前 BMI 和新生儿出生体重与尿失禁有直接关系。
本研究证实，妊娠和阴道分娩时的尿失禁与产后尿失禁的关系最强。此外，产妇在分娩时的直立姿势并不能降低尿失禁的可能性。对这个问题的认识有助于找到有效策略来降低女性尿失禁的可能性。
