Relationship Between Maternal Body Weight And Urinary Incontinence During Pregnancy And At Six Months Postpartum Among Primiparous Women

BACKGROUDMany researchers have conducted a lot of research on urinary incontinence(UI).There were some studies suggested a strong correlation between higher body mass index,weight gain and UI.Some studies have shown that women's high body mass index and weight gain are strongly correlated with the occurrence of urinary incontinence.In addition,some scholars have conducted small randomized controlled trials on obese patients with urinary incontinence.By reducing weight,they have greatly improved the quality of life of incontinent patients.In recent years,researchers have increasingly focused on the association between UI and maternal body weight during and after pregnancy.Therefore researchers are increasingly concerned about UI during pregnancy,and look forward to explore related factors affecting UI during and after pregnancy.For the reasons of participator,timing of the investigation,follow-up time,methods of survey,differences of medical level,and other factors,the relationship between maternal body weight,weight changes and UI still unclear.Therefore it is important to understand the status of UI during and after pregnancy,and explore relation between maternal body weight and UI.It is helpful to guide the weight control of pregnancy and improve the quality of life.From the above,a longitudinal observational study will be taken to obtain the status of pregnant women's weight and UI in primiparous women and explore the relationship between maternal body weight and UI during and after pregnancy.Results of our study will help medical staff to take preventive measures against high-risk groups early,to provide scientific evidence for further studies.OBJECTIVE1.This study aims to investigate the status of UI at the third trimester of pregnancy and at six months postpartum in primiparous women,and analysis UI type,composition ratio,number of leakage,leakage urine,severity,and the impact on the everyday life.2.To explore the relationship between UI at the third trimester of pregnancy and pre-pregnancy BMI,pre-pregnancy weight,weight gain during pregnancy,BMI gain during pregnancy,BMI at delivery and weight at delivery.3.To explore the relationship between UI at six months postpartum and pre-pregnancy BMI,pre-pregnancy weight,weight gain during pregnancy,BMI gain during pregnancy,BMI,weight at delivery,BMI at six months postpartum,weight at six months postpartum,weigh gain at six months postpartum,and BMI gain at six months postpartum.STUDY SUBJECTS AND METHODS1.Subjects The study population consisted of primiparous women who attended three hospitals in the Guangdong province of China and gave birth between 37+0 and 41+6 weeks of gestation from August 2015 to January 2016.All primiparous qualified with the criterion and agree to participate were included in our research.2.Data Collection ?Within 3 days after delivery,we did the first investigation to collect information about social demographic,pregnancy,delivery and UI at third trimester,.? Follow up:At 6 months after delivery,we contacted the participator again.During the telephone interview,related information about six months postpartum such as weight,UI,postpartum exercise,postpartum pelvic floor exercise,breast-feeding were investigated.3.statistics and analysis We used EpiData Version3.1 to establish database.After two person input data independently,consistency test was conduct to automatically detect data entry errors.SPSS version 20.0(SPSS,Inc.,Chicago,IL,USA)was used for data analysis.Binary logistic regression models were created with all of the first-order interaction terms to assess whether there was interaction between the effect modifiers,which showed a significant relationship with UI in the univariate analyses.A 2-sided P value of<0.05 was defined as being of statistical significance.RESULTS1.Basic Information of Participator714 primipara were included into this study at the first time interview.Finally 507 completed the follow-up.The effective follow-up rate was 71.0%.2.Status of UI at the third trimesterThe prevalence rates of UI,SUI,MUI,and OUI at the third trimester of pregnancy were 26.9%,18.1%,2.9%,1.0%and 4.9%,respectively.Among the 192 patients with urinary incontinence,most of urine leakage were<3 times per week(82.3%);99.0%were small amount of leakage of urine;72.9%of urinary incontinence were moderate and severe.3.Status of UI at six months postpartumThe prevalence rates of UI,SUI,MUI,and OUI at six months postpartum were 8.5%,6.1%,0.4%,0.8%and 1.2%,respectively.Among the 43 patients with urinary incontinence,most of urine leakage were<1 times per week(83.7%);93.0%were small amount of leakage of urine;95.4%of urinary incontinence were moderate and severe.4.The relationship between maternal body weight and UI during the third trimester of pregnancy and at six months postpartumLogistics regression results showed that after excluding abortion,pre-pregnancy weight(OR = 1.028,95%CI.1.005?1.051)was a risk factor for UI at the third trimester of pregnancy.Logistics regression results show that after excluding three factors(lateral episiotomy,exercise after delivery and UI at the third trimester of pregnancy,UI at 6 months postpartum correlated with BMI at six months postpartum(OR:1.127;95%CI:1.012-1.255).CONCLUSIONS1.UI during pregnancy and after delivery in primiparous women was unsatisfactory.The prevalence rates of UI at the third trimester of pregnancy and at six months postpartum were 26.9%and 8.5%,respectively.Moderate or severe UI occupied mostly both during(72.9%)and after delivery(95.4%).2.Pre-pregnancy weight was a risk factor UI at the third trimester of pregnancy even other factors co-exist.BMI at six months postpartum was related with UI after delivery,even other factors co-exist.Weight gain and weight retention were not associated with urinary incontinence during and after delivery.