Perinatal Incontinence Assessment Tools: A Psychometric Evaluation and Scoping Review

Approximately 40% of women report incontinence during pregnancy and postpartum (known as the perinatal period). Due to the lack of an established measurement standard, this scoping review aimed to investigate the psychometric properties of tools, which assess incontinence-related symptoms and quality of life (QOL) during this period. Articles in English, which assessed psychometric properties of tools for perinatal incontinence-related symptoms or QOL, were included and evaluated by a 16-item checklist. Nine databases were searched from 2000 to 2020. Four studies met the inclusion criteria, and five assessment tools were identified and included in this review. The modified Pelvic Floor Questionnaire (mPFQ), Leakage Index (LI), and International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) demonstrated internal consistency (Cronbach's α > 0.60, >0.70, and mean inter-item correlations >0.39, respectively). The mPFQ demonstrated moderate test-retest reliability (intraclass correlation coefficient >0.60). Construct validity of the ICIQ-UI SF was established by significant (p < 0.05) differences across age and obesity, whereas the mPFQ demonstrated significant (p < 0.001) discriminant validity in symptoms prepartum and postpartum. Convergent validity of telephone-administered Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) was established with the written version (p > 0.05, correlation coefficient >0.90). Responsiveness to change was described for the ICIQ-UI SF and mPFQ. The mPFQ and ICIQ-UI SF demonstrated acceptable reliability, validity, and responsiveness to change, therefore suggesting good clinical utility. Since most studies included primiparous women, future research in heterogeneous samples of women with perinatal incontinence may be needed.