Hersh Bayan, Shaban Rawan, Nazzal Zaher
Faculty of Medicine and Health Sciences, An-najah National University, Nablus, State of Palestine.
Community Medicine, Department of Medicine, An-Najah National University, Nablus, State of Palestine
BMJ Open. 2025 Jan 15;15(1):e087585. doi: 10.1136/bmjopen-2024-087585.
Urinary incontinence (UI) is prevalent among women, particularly during the postpartum period, impacting various aspects of quality of life (QoL). The objectives of this study are to determine the prevalence of postpartum UI among Palestinian women, explore its relationship with delivery mode, identify associated risk factors and assess its impact on QoL.
A cross-sectional study.
The study targeted postpartum women attending primary healthcare centres in the North West Bank of Palestine. Data were collected using interviewer-administered questionnaires. The primary outcome was the prevalence of postpartum UI, and the secondary outcomes included risk factors associated with UI and its impact on QoL. We used multivariate logistic regression analysis to identify factors associated with UI while adjusting for confounding variables. The Institutional Review Board of An-Najah National University approved the study.
Out of 507 participants, 13.6% (95% CI 10.8% to 16.9%) experienced postpartum UI, with 78.3% reporting moderate-to-severe symptoms. Maternal body mass index (BMI) (adjusted OR (aOR) 1.98; 95% CI 1.1 to 3.7; adjusted p=0.033) and experiencing UI during the last pregnancy (aOR 2.25; 95% CI 1.3 to 3.8; adjusted p=0.003) were significant risk factors for postpartum UI. No significant association was found between the normal vaginal delivery and postpartum UI compared with caesarean section (aOR 1.5; 95% CI 0.90 to 1.5; adjusted p=0.284). Postpartum UI severity significantly correlated with QoL, particularly in social embarrassment (p=0.005), psychosocial impact (p≤0.001) and avoidance and limiting behaviours (p≤0.001).
The prevalence of postpartum UI in Palestinian women is consistent with global findings. Experiencing UI during the last pregnancy and higher maternal BMI were identified as key risk factors for postpartum UI. These results highlight the need for early detection, intervention and preventive strategies to mitigate the impact of postpartum UI on QoL.
尿失禁（UI）在女性中很常见，尤其是在产后阶段，会影响生活质量（QoL）的各个方面。本研究的目的是确定巴勒斯坦女性产后尿失禁的患病率，探讨其与分娩方式的关系，确定相关危险因素，并评估其对生活质量的影响。
一项横断面研究。
该研究针对在巴勒斯坦约旦河西岸初级医疗保健中心就诊的产后女性。通过访员管理的问卷收集数据。主要结果是产后尿失禁的患病率，次要结果包括与尿失禁相关的危险因素及其对生活质量的影响。我们使用多变量逻辑回归分析来确定与尿失禁相关的因素，同时对混杂变量进行调整。纳贾赫国立大学机构审查委员会批准了该研究。
在507名参与者中，13.6%（95%置信区间10.8%至16.9%）经历了产后尿失禁，78.3%报告有中度至重度症状。产妇体重指数（BMI）（调整后的比值比（aOR）为1.98；95%置信区间1.1至3.7；调整后p = 0.033）以及上次怀孕时出现尿失禁（aOR为2.25；95%置信区间1.3至3.8；调整后p = 0.003）是产后尿失禁的重要危险因素。与剖宫产相比，正常阴道分娩与产后尿失禁之间未发现显著关联（aOR为1.5；95%置信区间0.90至1.5；调整后p = 0.284）。产后尿失禁的严重程度与生活质量显著相关，尤其是在社交尴尬方面（p = 0.00'）、心理社会影响方面（p≤0.001）以及回避和限制行为方面（p≤0.001）。
巴勒斯坦女性产后尿失禁的患病率与全球研究结果一致。上次怀孕时出现尿失禁和较高的产妇BMI被确定为产后尿失禁的关键危险因素。这些结果凸显了早期检测、干预和预防策略的必要性，以减轻产后尿失禁对生活质量的影响。
