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Maternal, Obstetrical and Neonatal Risk Factors’ Impact on Female Urinary Incontinence: A Systematic Review Publisher Pubmed



Siahkal SF1 ; Iravani M2 ; Mohaghegh Z3 ; Sharifipour F4 ; Zahedian M5
Authors
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Authors Affiliations
  1. 1. Department of Midwifery, Marand Branch, Islamic Azad University, Marand, Iran
  2. 2. Reproductive Health Promotion Research Center, Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  3. 3. Unit of Family Health, Health Deputy of Tehran University of Medical Science, Tehran, Iran
  4. 4. Midwifery Department, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
  5. 5. Librarian of Nursing and Midwifery Department, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran

Source: International Urogynecology Journal Published:2020


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. © 2020, The International Urogynecological Association.
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