Gallego-Gómez Cristina, Rodríguez-Gutiérrez Eva, Torres-Costoso Ana, Martínez-Vizcaíno Vicente, Martínez-Bustelo Sandra, Quezada-Bascuñán Claudia Andrea, Ferri-Morales Asunción
Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Toledo, Spain; Physiotherapy Unit, Health Center of Camarena, Toledo, Spain; Toledo Physiotherapy Research Group (GIFTO), University of Castilla-La Mancha, Toledo, Spain.
Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain.
Am J Obstet Gynecol. 2024 Sep;231(3):296-307.e11. doi: 10.1016/j.ajog.2024.02.307. Epub 2024 Mar 2.
Postpartum depression is one of the most common complications after childbearing. Urinary incontinence is a frequent symptom during pregnancy and the postnatal period, often being the first time that women experience it. This systematic review and meta-analysis aimed to synthesize the evidence on the association between urinary incontinence and postpartum depression and to assess whether this association becomes weaker at 6 months after childbirth.
MEDLINE, Embase, Cochrane Library, Web of Science, and PsycINFO were searched from inception to December 26, 2023.
Cross-sectional and cohort studies addressing the association between urinary incontinence and postpartum depression were included.
Pooled odds ratios and their 95% confidence intervals, and 95% prediction intervals were estimated using a DerSimonian and Laird random-effects model for the association between urinary incontinence and postpartum depression. Subgroup analyses were conducted on the basis of time after delivery (<6 or ≥6 months). The risk of bias was assessed with the National Institutes of Health Quality Assessment Tool for Observational Cohort Studies.
Eleven published studies were included in the systematic review and meta-analysis. Overall, the odds ratio for the association between urinary incontinence and postpartum depression was 1.45 (95% confidence interval, 1.11-1.79; 95% prediction interval, 0.49-2.40; I=65.9%; P=.001). For the 7 cohort studies, the odds ratio was 1.63 (95% confidence interval, 1.35-1.91; 95% prediction interval, 1.14-2.13; I=11.1%; P=.345). For the 4 cross-sectional studies, the odds ratio was 1.05 (95% confidence interval, 1.04-1.05; 95% prediction interval, 1.04-1.06; I=0.0%; P=.413). According to the time after delivery, the odds ratio estimates for cohort studies with a postpartum period <6 months were 1.44 (95% confidence interval, 1.07-1.81; prediction interval, 0.63-2.25; I=0.0%; P=.603) and 1.53 (95% confidence interval, 1.16-1.89; prediction interval, 0.41-2.65; I=50.7%; P=.087) for those with a postpartum period ≥6 months.
This systematic review and meta-analysis suggests that urinary incontinence may be a potential predictor of postpartum depression. Thus, it is important that health care professionals offer support and treatment options to women who experience these conditions.
产后抑郁症是产后最常见的并发症之一。尿失禁是孕期及产后的常见症状，女性往往首次经历此症状。本系统评价和荟萃分析旨在综合尿失禁与产后抑郁症之间关联的证据，并评估这种关联在产后6个月时是否减弱。
检索了MEDLINE、Embase、Cochrane图书馆、Web of Science和PsycINFO，检索时间从数据库建立至2023年12月26日。
纳入探讨尿失禁与产后抑郁症之间关联的横断面研究和队列研究。
采用DerSimonian和Laird随机效应模型估计尿失禁与产后抑郁症之间关联的合并比值比及其95%置信区间和95%预测区间。根据分娩后的时间（<6个月或≥6个月）进行亚组分析。采用美国国立卫生研究院观察性队列研究质量评估工具评估偏倚风险。
系统评价和荟萃分析纳入了11项已发表的研究。总体而言，尿失禁与产后抑郁症之间关联的比值比为1.45（95%置信区间为1.11 - 1.79；95%预测区间为0.49 - 2.40；I² = 65.9%；P = 0.001）。对于7项队列研究，比值比为1.63（95%置信区间为1.35 - 1.91；95%预测区间为1.14 - 2.13；I² = 11.1%；P = 0.345）。对于4项横断面研究，比值比为1.05（95%置信区间为1.04 - 1.05；95%预测区间为1.04 - 1.06；I² = 0.0%；P = 0.413）。根据分娩后的时间，产后<6个月的队列研究的比值比估计值为1.44（95%置信区间为 &
