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Antenatal screening for postpartum urinary incontinence in nulliparous women: a pilot study
Douglas G Tincello1, Elisabeth J Adams, David H Richmond
1University of Liverpool, Department of Obstetrics & Gynaecology, Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK. tincello@liv.ac.uk
Unlabelled:
Antenatal screening for postpartum urinary incontinence in nulliparous women: a pilot study.
Objective:
To examine the utility of joint mobility scoring (JMS) as a screening test for postpartum urinary incontinence.
Study Design:
A prospective cohort study in a teaching hospital involving 150 nulliparous women. JMS was calculated. The incidence of incontinence and pad use was recorded. Univariate and multiple logistic regression analyses were used to identify factors independently associated with incontinence.
Results:
Hundred and three women completed the study. 43.7% of subjects were incontinent antenatally and 4.9% remained incontinent at the study end. JMS was normally distributed and similar in continent and incontinent women. Elbow hyperextension (>180 degrees ) was associated with postnatal incontinence (odds ratio 10.6; 95% CI 1.24, 90.8). Elbow hyperextension had a sensitivity of 80%, specificity of 75%, positive predictive value of 14%, and negative predictive value of 99% for postnatal incontinence.
Conclusion:
Joint hypermobility score is not a useful screening test. Elbow hyperextension is associated with an increased likelihood of postnatal urinary incontinence. It is unclear whether this test has clinical utility outside a research setting.