Proportion, quality if life and factors associated with perinatal urinary incontinence at Muhimbili National Hospital

Abstract

ABSTRACT Introduction: Perinatal Urine Incontinence (PUI) is the condition affecting around 200 million women worldwide. It is hypothesized that it has a multifactorial etiology that includes hormonal changes, pregnancy, urethral angle changes, and childbirth-related forces. The prevalence of PUI ranges from 32% to 64%. These conditions affect the quality of life, leading to significant physical and emotional distress, self-esteem, social interactions, postpartum depression and anxiety. Determination of factors associated with PUI and provide appropriate support and treatment options for women experiencing perinatal urinary incontinence can improve the well-being of those affected. Objectives: The aim is to assess the proportion, quality of life and factors associated with perinatal urinary incontinence among pregnant women admitted to the Muhimbili National Hospital Methodology: Prospective cross-sectional study. Structured questionnaire was given to all 354 pregnant women in perinatal period, and ICIQ-UI SF Tool was given only to individuals who had urine incontinence to evaluate their quality of life. Descriptive statistics and categorical data were described by frequency tables, graphs, and percentages, and numerical variables by mean, median, and standard deviation. Bivariate logistic regression was used to obtain variables that have an association with PUI. Multivariate logistic regression for the control effect of confounders. Results: The mean age of the participants was 30 years (range 30–34 years). The overall proportion of PUI among the participants was 59 [16.7%]. Of the total participants with PUI, 28 (49.1%) had SUI, 9 (15.8%) had UUI, MUI, and 1 (1.8%). Overall, among the participants who had PUI, quality of life was moderately affected in 31 (52.5%) participants, followed by 17 (28.8%) whose QoL was slightly affected, 10 (16.9%) whose QoL was poor, and only 1 (1.7%) whose quality of life was very poor. In the multivariable logistic regression model, factors associated during the perinatal period were significantly associated with PUI, with a p value <0.05. A significant association between UI and a normal BMI, pre-obesity [AOR 1.351 95% CI 1.161 1.765], grand multipara [AOR 1.092 95% CI 1.027-1.323], and a previous history of cesarean section [AOR. 5.126 95% CI 2.081-12.628] Conclusion: Perinatal urinary incontinence significantly affects morbidity at different levels, even though it is not a life-threatening disease. The burden of UI on daily life activities, sexual function, interpersonal relationships, social interactions and psychological well-being may be substantial; however, women’s different perceptions may change their relative impact on QoL.