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 (RR_a, 4.58; 95% CI, 1.68–12.46) and less than six prenatal appointments (RR_a, 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.

中文翻译：

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阴道分娩后初产青少年尿失禁的危险因素：一项队列研究。

学习目标

评估阴道分娩后 7 至 48 个月初产青少年的尿失禁 (UI) 危险因素。

设计

队列研究。

环境

伯南布哥联邦大学女性健康和盆底物理治疗实验室。

参与者、干预措施和主要结果指标

队列随访时间为分娩后 7-48 个月，确保在婴儿出生后 7 个月内没有参与者出现 UI。该研究包括了 10-19 岁的初产青少年，排除了那些在怀孕期间患有 UI 的人。考虑到逻辑回归的计算，样本量估计为 140 名志愿者，为研究开发的理论模型中提出的 7 个变量中的每一个变量有 20 个观察单位。志愿者回答了评估表，提供了有关感兴趣的结果和可能的风险因素的信息。进行单变量逻辑回归分析。

结果

在阴道分娩后的初产青少年中确定了以下 UI 风险因素：会阴切开术（相对风险 [RR] _a 2.75；95% 置信区间 [CI] 1.22-6.06），大于胎龄的新生儿（RR _a 4.58； 95% CI，1.68–12.46）和少于六次产前检查（RR _a，2.51；95% CI，1.05–6.04）。

结论

从事孕产妇保健工作的专业人员应特别注意初产妇，指导产前预约，避免常规会阴切开术，并使用世界卫生组织推荐的产科实践。