Prevalence of postpartum urinary incontinence: a systematic review

Abstract

Objective: to investigate the prevalence of urinary incontinence within the first year postpartum.

Design: a systematic review of population-based studies.

Population: general female populations up to 1 year postpartum.

Methods: studies on incontinence in population-based sample defined as from one or more district hospitals or from multiple clinics covering a defined geographic area. Studies of women from a single outpatient clinic or who were referred for care (e.g. for being high risk) were excluded. In addition, studies had to have a sample size of over 100 participants and a response rate 50% or over.

Main outcome measures: prevalence from individual studies as well as mean prevalence is given. Pooled prevalence is estimated for non-heterogenous studies.

Results: during the first 3 months postpartum, the pooled prevalence of any postpartum incontinence was 33% (95% confidence interval (CI) 32-36%) in all women. The mean prevalence of weekly and daily incontinence was 12% (95% CI 11-13%) and 3% (95% CI 3-4%), respectively. The mean prevalence was double in the vaginal delivery group (31%, 95% CI 30-33%) compared to the cesarean section group (15%, 95% CI 11-18%). Longitudinal studies within the first year postpartum showed small changes in prevalence over time.

Conclusions: the prevalence of postpartum incontinence was high. Prevalence was substantially less for more frequent incontinence. Urinary incontinence after cesarean section was half the prevalence after vaginal delivery.