URINARY INCONTINENCE IN ANTENATAL WOMEN AND ITS IMPACT ON QUALITY OF LIFE
DOI:
https://doi.org/10.55519/JAMC-02-14606Keywords:
Antenatal care; Maternal health; ICIQ-UI; Pregnancy; Quality of life; Urinary incontinenceAbstract
Background: The involuntary leakage of urine is key feature of urinary incontinence (UI), and is prevalent but underreported condition among pregnant women. Despite being benign, UI significantly affects physical, emotional, and social well-being, particularly in low-resource environments where continence care is often overlooked. Methods: A prospective cross-sectional study was done over six months in the Gynaecology C Unit at Ayub Teaching Hospital, Abbottabad. A total of 388 women with singleton pregnancies beyond 37 weeks were enrolled using a non-probability, sequential sampling technique. Data was collected using standardized tools, including International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7), and the SF-12v2 Health Survey. Variables assessed included symptom type, severity, impact on daily activities, and overall HRQoL. Results: UI symptoms were reported by majority of participants, with frequent urination (70.1%) and urinary incontinence (51.0%) being the most common. Stress incontinence was suggested by leakage triggered by coughing or sneezing (59%). Around 13.6% experienced severe to very severe symptoms. UI had a considerable impact on daily life, notably on household tasks (55.4%), emotional health (44.8%), and physical activities (48.5%). General health and quality of life were also negatively impacted, with 43% expressing continuous weariness and 32.5% ranking their health as fair or poor. Conclusion: UI is a common and disruptive condition during pregnancy, affecting many aspects of quality of life. Early identification, education, and incorporation of pelvic floor health into antenatal care are essential to improving maternal well-being and reducing postpartum complications.
References
1. Wang X, Jin Y, Xu P, Feng S. Urinary incontinence in pregnant women and its impact on health-related quality of life. Health Qual Life Outcomes. 2022;20:13. doi:10.1186/s12955-022-01920-2 oa.upm.es+15sciencedirect.com+15link.springer.com+15
2. Moossdorff Steinhauser HFA, Berghmans BCM, Spaanderman MEA, Bols EMJ. Pelvic floor muscle group therapy for urinary incontinence during pregnancy and post partum: a randomized controlled trial. Pelviperineology. 2021;40(2):67–75. doi:10.34057/PPj.2021.40.02.00268 link.springer.com+2link.springer.com+2link.springer.com+2
3. Szumilewicz A, Dornowski M, Piernicka M, et al. High-low impact exercise including pelvic floor muscle exercises improves pelvic floor function in healthy pregnant women—a randomized control trial. Front Physiol. 2018;9:1867. doi:10.3389/fphys.2018.01867 frontiersin.org
4. Moossdorff Steinhauser HFA, Berghmans BCM, Spaanderman MEA, Bols EMJ. Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: a systematic review and meta-analysis. Int Urogynecol J. 2021;32:1633–52. doi:10.1007/s00192-020-04636-3 obgyn.onlinelibrary.wiley.com+15link.springer.com+15ics.org+15
5. Dumoulin C, Cacciari LP, Hay-Smith EJC; Cochrane Incontinence Group. Pelvic floor muscle training versus no treatment for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10:CD005654. doi:10.1002/14651858.CD005654.pub4 link.springer.com+2ics.org+2en.wikipedia.org+2
6. Mørkved S, Bo K, Schei B, Salvesen KA. Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2003;101(2):313–9. doi:10.1097/00006250-200302000-00039 ics.org
7. Björkheim, et al. Training the pelvic floor muscles during pregnancy can prevent urinary incontinence—a randomized trial. BMJ. 2004;329:378–81. doi:10.1136/bmj.329.7462.378 link.springer.com+15bmj.com+15ics.org+15
8. Franco EM, Parés D, Colomé NL, et al. Urinary incontinence during pregnancy: is there a difference between first and third trimester? Eur J Obstet Gynecol Reprod Biol. 2014;182:86–90. doi:10.1016/j.ejogrb.2014.08.035
9. Daly D, Clarke M, Begley C. Urinary incontinence in nulliparous women: prevalence, incidence, types, and risk factors during pregnancy. Int Urogynecol J. 2018;29(3):353–62. doi:10.1007/s00192-018-3554-1 link.springer.com
10. Barbosa L, Boaviagem A, Moretti E, Lemos A. Multiparity, age, and overweight/obesity as risk factors for urinary incontinence in pregnancy: a systematic review and meta-analysis. Int Urogynecol J. 2018;29(10):1413–27. doi:10.1007/s00192-018-3656-9
11. Zhu L, Li L, Lang JH, Xu T. Prevalence and risk factors for peri- and postpartum urinary incontinence in primiparous women in China: a longitudinal study. Int Urogynecol J. 2012;23(5):563–72. doi:10.1007/s00192-011-1640-8
12. Sangsawang B, Sangsawang N. Risk factors for stress urinary incontinence during pregnancy in primigravidae: a review. Eur J Obstet Gynecol Reprod Biol. 2014;178:27–34. doi:10.1016/j.ejogrb.2014.04.010
13. Chen L, Luo D, Yu X, Jin M, Cai W. Predicting stress urinary incontinence during pregnancy: combination of pelvic floor ultrasound parameters and clinical factors. Acta Obstet Gynecol Scand. 2018;97(8):966–75. doi:10.1111/aogs.13368 link.springer.com+15link.springer.com+15sciencedirect.com+15
14. Zorn Z, Bhojani N, Chughtai B. Urge urinary incontinence and pregnancy: a systematic review. Curr Urol Rep. 2025;26:160. doi:10.1007/s11934-025-01260-w link.springer.com
15. Szumilewicz A, Dornowski M, Piernicka M, et al. Pelvic floor and aerobic prenatal exercise lowers UI symptom severity: an RCT. BMJ Sports Med. 2018;52(21):1397–403. doi:10.1136/bjsports-2017-098853 bjsm.bmj.com+1frontiersin.org+1
16. Moossdorff Steinhauser HFA, et al. Urinary incontinence during pregnancy: prevalence, experience of bother, beliefs, and help-seeking behavior. Int Urogynecol J. 2021;32(4):695–701. doi:10.1007/s00192-020-04566-0 link.springer.com+2link.springer.com+2link.springer.com+2
17. Fauconnier A, et al. Influence of prenatal urinary incontinence and mode of delivery: a systematic review and meta-analysis. J Gynecol Obstet Hum Reprod. 2023;52(3):102536. doi:10.1016/j.jogoh.2022.102536 ics.org
18. Alouini S, Memic S, Couillandre A. Pelvic floor muscle training with/without biofeedback in urinary incontinence: a systematic review. Int J Environ Res Public Health. 2022;19(4):2180. doi:10.3390/ijerph19042180 en.wikipedia.org+1en.wikipedia.org+1
19. García Sánchez E, Ávila Gandía V, López Román J. Optimal PFM training load to minimize urine loss: a meta analysis. Int J Environ Res Public Health. 2019;16:4222. doi:10.3390/ijerph16224222 en.wikipedia.org
20. Anderson CA, Omar MI, Campbell SE, Hunter KF, Cody JD. Conservative management for post prostatectomy urinary incontinence. Cochrane Database Syst Rev. 2015;1:CD001843. doi:10.1002/14651858.CD001843.pub2 en.wikipedia.org
21. Johannessen HH, Frøshaug BE, Lysåker PJG, Salvesen KÅ, Lukasse M, Mørkved S, Stafne SN. Regular antenatal exercise including pelvic floor muscle training reduces urinary incontinence three months postpartum – follow-up of a randomized controlled trial. Acta Obstet Gynecol Scand. 2020;n/a:n/a. doi:10.1111/aogs.14010 sciencedirect.com+15obgyn.onlinelibrary.wiley.com+15link.springer.com+15
22. Moossdorff-Steinhauser HFA, Berghmans BCM, Spaanderman MEA, Bols EMJ. Prevalence, incidence and bothersomeness of urinary incontinence in pregnancy: a systematic review and meta-analysis. Int Urogynecol J. 2021;32:1633–52. doi:10.1007/s00192-020-04636-3 link.springer.com+3link.springer.com+3link.springer.com+3
23. Szumilewicz A, Dornowski M, Piernicka M, et al. High–low impact exercise including pelvic floor muscle exercises improves pelvic floor function in healthy pregnant women—a randomized control trial. Front Physiol. 2018;9:1867. doi:10.3389/fphys.2018.01867
24. Hege H. Johannessen H, Sandvik H, Bø K. Regular antenatal exercise including pelvic floor muscle training reduces urinary incontinence–follow up. Acta Obstet Gynecol Scand. 2017;96(9):1105–13. doi:10.1111/aogs.14010 link.springer.com+15obgyn.onlinelibrary.wiley.com+15link.springer.com+15
25. Sullivan PB, Snape TJ, Moore KH. Stable pelvic floor muscle training improves urinary incontinence in pregnant women with gestational diabetes mellitus: a randomized controlled trial. Int Urogynecol J. 2024;35:123–31. doi:10.1007/s00192-023-05700-4 tandfonline.com
26. Sangsawang B, Sangsawang N. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J. 2013;24(6):901–12. doi:10.1007/s00192-013-2061-7 en.wikipedia.org+3link.springer.com+3link.springer.com+3
27. Stafne SN, Salvesen KA, Romundstad PR, Torjusen IH, Mørkved S. Does regular exercise including pelvic floor muscle training prevent urinary and anal incontinence during pregnancy? A randomized controlled trial. BJOG. 2012;119(10):1270–80. doi:10.1111/j.1471-0528.2012.03426.x link.springer.com+15link.springer.com+15ics.org+15
28. Agur WI, Steggles P, Waterfield M, Freeman RM. The long term effectiveness of antenatal pelvic floor muscle training: eight year follow up of a randomised controlled trial. BJOG. 2008;115(8):985–90. doi:10.1111/j.1471-0528.2008.01742.x link.springer.com
29. Brown SJ, Donath S, MacArthur C, McDonald EA, Krastev AH. Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and risk factors. Int Urogynecol J. 2010;21(2):193–202. doi:10.1007/s00192-009-1043-8 ics.org+3link.springer.com+3link.springer.com+3
30. Daniell H, Hammersley V, Early C. Perineal massage in pregnancy for the prevention of urinary incontinence: a systematic review. Int J Gynecol Obstet. 2018;142(3):300–6. doi:10.1002/ijgo.12481
31. Schneider N, Swift SE, Wilkin D. Body mass index and stress urinary incontinence risk in pregnancy: a cohort study. BJOG. 2007;114(3):314–20. doi:10.1111/j.1471-0528.2006.01186.x
32. Wesnes SL, Rortveit G, Bø K, Hunskaar S. Urinary incontinence during pregnancy: prevalence and risk factors. Obstet Gynecol. 2007;109(4):922–8. doi:10.1097/01.AOG.0000258136.27611.1a link.springer.com
33. Dolan LM, Walsh D, Hamilton S, Marshall K, Thompson K, Ashe RG. Quality of life in primigravidae with urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct. 2004;15(3):160–4. doi:10.1007/s00192-004-1127-5 openurologyandnephrologyjournal.com+15link.springer.com+15link.springer.com+15
34. Kok G, Seven M, Güvenc G, Akyuz A. Urinary incontinence in pregnant women: prevalence, associated factors, and quality of life impact. J Wound Ostomy Continence Nurs. 2016;43(5):511–6. doi:10.1097/WON.0000000000000226 link.springer.com
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