Study On Effect Of Gravidity And Delivery On Risk Factors Of Urinary Incontinence

Objective : To investigate the morbidity of stress urinary incontinence in pregnancy and puerperium in primiparae by means of questionnaire and to evaluate the effect of the risk factors in pregnancy and delivery to the incidence of stress urinary incontinence, providing basis to the prevention and treatment of such a desease.Methods:330 primipara, delivered from March to September 2010 in Dalian maternity hospital and were followed up 6 weeks after delivery, were recruited and their symptoms of stress urinary incontinence during and after pregnancy were investigated. General information and related factors of the pregnancy and delivery were recorded. The questionnaire was designed according to International Continence Society. The incidence and degree of stress urinary incontinence were evaluated. All cases were followed up 6 months. 301 cases of effective questionnaire were analyzed by SPSS software in order to evaluate the risk factors of stress urinary incontinence.Results:1) 112 of 301(37.21%) women complained of urinary leakage. 99 of 301(32.89%) women complained of urinary leakage at least once during pregnancy, and 28 of 301(9.33%) women complained of urinary leakage at least once after delivery. Follow-up to postpartum 6 months, only 6(9.30%) patients with stress urinary incontinence.16 of 99 women still suffered from stress urinary incontinence after delivery. 2 of 16 Continued to postpartum 6 months. 1 of 99 Suffered from stress urinary incontinence after postpartum 6 weeks, and Continued to postpartum 6 months. 12 of 301 First appeared with stress urinary incontinence after delivery,3 of 12 Continued to postpartum 6 months.2) According to logistic regression, BMI before pregnancy was associated factor with stress urinary incontinence during pregnancy(P<0.05). 3) According to logistic regression, the three factors that associated with postpartum stress urinary incontinence were the occurrence of urinary incontinence during pregnancy, the mode of delivery, and the BMI before pregnancy(P<0.05).4) The incidence of stress urinary incontinence in spontaneous vaginal and cesarean section delivery was 13.77%(23/167),3.73%(5/134),and the incidence of postpartum stress urinary incontinence in spontaneous vaginal delivery was also higher than that of the cesarean section group(P<0.05).5) The risk factors to postpartum stress urinary incontinence in vaginal delivery were the occurrence of urinary incontinence during pregnancy, the BMI before pregnancy, and the forceps(P<0.05). But the other events, such as the age of Childbirth, the duration of the second period of delivery, episiotomy and fetal weight, were not correlated.6) the degree of stress urinary incontinence:Turing pregnancy, 69 of 99(69.70%) are mild, 30 of 99(30.30%) are moderate, without severe patients;Postpartum 6 weeks, 20 of 28(71.43%) are mild, 8 of 28(28.57%) are moderate, without severe patients;Postpartum 6 months, 5 of 6(83.33%) are mild, 1 of 6(16.67%) is moderate, without severe patients.Conclusion:1) Stress urinary incontinence during pregnancy and the postpartum early is high, symptoms mostly disappeared within Postpartum 6 months.2) BMI(BMI≥24㎏/㎡) before pregnancy is significant risk factor of stress urinary incontinence during pregnancy.3) occurrence of urinary incontinence during pregnancy, the BMI(BMI≥24㎏/㎡) before pregnancy, and the vaginal delivery are significant risk factors of postpartum stress urinary incontinence.4) Cesarean section can significant decrease the incidence of postpartum stress urinary incontinence than vaginal delivery within Postpartum 6 months5) Occurrence of urinary incontinence during pregnancy, the BMI(BMI≥24㎏/㎡) before pregnancy, and the forceps are significant risk factors of postpartum stress urinary incontinence in vaginal delivery.6) The symptoms of the most women during and after pregnancy are mild, Pelvic floor exercise during pregnancy and after delivery is valid to prevent postpartum stress urinary incontinence.