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Published on: September 20, 2018
Risk Factors for Urinary Incontinence in Primiparous Adolescents after Vaginal Delivery: A Cohort Study
Dominique Babini1, Andrea Lemos1
1Graduate Program in Child and Adolescent Health, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Department of Physical Therapy, Federal University of Pernambuco, Recife, Pernambuco, Brazil.
Study Objective:
To evaluate urinary incontinence (UI) risk factors in primiparous adolescents between 7 and 48 months after vaginal delivery.
Design:
Cohort study.
Setting:
Physical Therapy Laboratory on Women's Health and Pelvic Floor at the Federal University of Pernambuco.
Participants, Interventions, And Main Outcome Measures:
Cohort follow-up time was 7-48 months after delivery, guaranteeing that no participant presented with UI until 7 months after the infant's birth. Primiparous adolescents aged 10-19 years were included in the study, and those who had UI during pregnancy were excluded. Sample size was estimated at 140 volunteers, considering the calculation for logistic regression, with 20 observation units for each of the 7 variables proposed in the theoretical model developed for the study. The volunteers answered the evaluation form, providing information on the outcome of interest and possible risk factors. Univariate logistic regression analysis was performed.
Results:
The following risk factors for UI were identified in primiparous adolescents after vaginal delivery: episiotomy (Relative risk [RR]a, 2.75; 95% confidence interval [CI], 1.22-6.06), large newborn for gestational age (RRa, 4.58; 95% CI, 1.68-12.46) and less than six prenatal appointments (RRa, 2.51; 95% CI, 1.05-6.04).
Conclusion:
Professionals working in maternal health care should pay special attention to primigravid mothers, guide prenatal appointments, avoid routine episiotomy, and use obstetric practices recommended by the World Health Organization.
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