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Maternal, obstetrical and neonatal risk factors’ impact on female urinary incontinence: a systematic review

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Abstract

Introduction and hypothesis

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.

Methods

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.

Results

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.

Conclusions

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.

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Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author.

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Acknowledgments

The authors thank the authors of the original studies who responded to requests for data or clarifications.

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Authors and Affiliations

  1. Department of Midwifery, Marand Branch, Islamic Azad University, Marand, Iran

    Shahla Faal Siahkal

  2. Reproductive Health Promotion Research Center, Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Mina Iravani

  3. Unit of Family Health, Health Deputy of Tehran University of Medical Science, Tehran, Iran

    Zeynab Mohaghegh

  4. Midwifery Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran

    Foruzan Sharifipour

  5. Librarian of Nursing and Midwifery Department, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran

    Maryam Zahedian

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  1. Shahla Faal Siahkal
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Contributions

SHF, MI, ZM, FSH, MZ.

Study concept and design: SHF and MI.

Search: MZ.

Screening: SHF, FSH.

Data extraction: SHF, FSH.

Quality assessment: SHF, FSH, ZM.

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Correspondence to Mina Iravani.

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Siahkal, S.F., Iravani, M., Mohaghegh, Z. et al. Maternal, obstetrical and neonatal risk factors’ impact on female urinary incontinence: a systematic review. Int Urogynecol J 31, 2205–2224 (2020). https://doi.org/10.1007/s00192-020-04442-x

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  • DOI: https://doi.org/10.1007/s00192-020-04442-x

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