Andarini Esti, Liang Surui, Zhang Yingying, Li Yanyan, Li Yan, Cai Wenzhi
School of Nursing, Southern Medical University, Guangzhou, Guangdong Province, China.
Department of Nursing, Politeknik Negeri Subang, Subang, West Java, Indonesia.
PeerJ. 2025 May 30;13:e19308. doi: 10.7717/peerj.19308. eCollection 2025.
The prevalence of urinary incontinence (UI) during pregnancy and the postpartum period can have significant negative impacts, including on the quality of life and economic burden for affected women.
The objective of this study was to develop risk-predictive models for postpartum stress urinary incontinence (SUI) among women in Indonesia.
Between January 2023 and March 2023, 430 postpartum women, aged 18 years or older, who were admitted to two study hospitals in Indonesia, were enrolled in this study. Telephone follow-up was conducted at six weeks postpartum to assess the presence of SUI. The Least Absolute Shrinkage and Selection Operator (LASSO) method was utilized to identify the relevant variables, and generalized linear models (GLM) were employed to establish predictive models for postpartum SUI. The models were internally validated using a bootstrapping method with 1,000 resamplings to assess discrimination and calibration.
The analysis included 430 participants, among whom the prevalence of postpartum SUI was found to be 21% (90 out of 430). The predictive model for postpartum SUI included pre-pregnancy body mass index (BMI), Kegel exercises, constipation, fetal weight, SUI during pregnancy, and mode of delivery. The models demonstrated satisfactory calibration, as indicated by the Hosmer-Lemeshow test ( = 0.390). The optimism-corrected C-statistic, determined through bootstrapping stepwise, was 0.763 (95% confidence interval CI [0.693-0.833]) for postpartum women.
This study successfully developed predictive models for SUI among postpartum women in Indonesia. The implementation of this model may serve as a valuable tool for identifying high-risk individuals at post-delivery stages, aiding in the prevention and management of postpartum SUI.
妊娠及产后尿失禁（UI）的患病率可能产生重大负面影响，包括对受影响女性的生活质量和经济负担。
本研究的目的是为印度尼西亚女性开发产后压力性尿失禁（SUI）的风险预测模型。
在2023年1月至2023年3月期间，430名年龄在18岁及以上、入住印度尼西亚两家研究医院的产后女性被纳入本研究。在产后六周进行电话随访，以评估SUI的存在情况。采用最小绝对收缩和选择算子（LASSO）方法识别相关变量，并使用广义线性模型（GLM）建立产后SUI的预测模型。使用1000次重采样的自举法对模型进行内部验证，以评估区分度和校准情况。
分析包括430名参与者，其中产后SUI的患病率为21%（430人中的90人）。产后SUI的预测模型包括孕前体重指数（BMI）、凯格尔运动、便秘、胎儿体重、孕期SUI和分娩方式。如Hosmer-Lemeshow检验所示（=0.390），模型显示出令人满意的校准。通过逐步自举法确定的乐观校正C统计量，产后女性为0.763（95%置信区间CI[0.693-0.833]）。
本研究成功为印度尼西亚产后女性开发了SUI预测模型。该模型的实施可能成为识别产后阶段高危个体的宝贵工具，有助于预防和管理产后SUI。
