BMJ open · 2025
Impact of postpartum urinary and anal incontinence on patient-reported quality of life and risk of depressive disorder in women receiving primary and secondary care in the Netherlands: a prospective cohort study.
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Mooren Ellen, Posthumus Anke G, Steensma Anneke, van der Kooy Jacoba, Speksnijder Leonie
Аннотация
OBJECTIVES: To explore how urinary (UI) and anal incontinence (AI) affect various aspects of quality of life (QoL) and the risk of depression 6 months postpartum, using patient-reported outcome measures (PROMs).
DESIGN: Prospective cohort study.
PARTICIPANTS AND SETTING: Women who gave birth between 2020 and 2022 within a local obstetric collaborative network in the Netherlands, including 13 midwifery practices, 5 maternity care organisations at the primary care level, and 1 secondary teaching hospital.
INTERVENTIONS: Prospectively collecting data by using the questionnaires of the International Consortium for Health Outcome Measures Pregnancy and Childbirth set at five moments during pregnancy and postpartum.
PRIMARY AND SECONDARY OUTCOME MEASURES: Associations between UI, AI, QoL and likelihood of depression based on PROMs collected from questionnaire 6 months postpartum.
RESULTS: Of the 663 women who completed the 6-month postpartum questionnaire, 79 women had severe UI, 71 had severe AI and 45 experienced both. These women reported significantly lower QoL as measured by PROMIS-10: 34 (IQR 30.5-38.5), 34 (IQR 30-39.5), and 32 (IQR 27-35), respectively, compared with a score of 37 (IQR 33-42) for the total population. Additionally, the positive rate for depression screening was notably higher among these groups, with rates of 6%, 10% and 18%, respectively, compared with 3% for the overall group.
CONCLUSIONS: In this observational cohort study, we found that severe UI and/or AI 6 months postpartum significantly impact QoL and increase the likelihood of depression, as indicated by PROMs. Our findings emphasise the importance of screening, evaluation and treatment of UI and/or AI to improve the QoL and reduce the risk of depressive disorders for postpartum women.
DESIGN: Prospective cohort study.
PARTICIPANTS AND SETTING: Women who gave birth between 2020 and 2022 within a local obstetric collaborative network in the Netherlands, including 13 midwifery practices, 5 maternity care organisations at the primary care level, and 1 secondary teaching hospital.
INTERVENTIONS: Prospectively collecting data by using the questionnaires of the International Consortium for Health Outcome Measures Pregnancy and Childbirth set at five moments during pregnancy and postpartum.
PRIMARY AND SECONDARY OUTCOME MEASURES: Associations between UI, AI, QoL and likelihood of depression based on PROMs collected from questionnaire 6 months postpartum.
RESULTS: Of the 663 women who completed the 6-month postpartum questionnaire, 79 women had severe UI, 71 had severe AI and 45 experienced both. These women reported significantly lower QoL as measured by PROMIS-10: 34 (IQR 30.5-38.5), 34 (IQR 30-39.5), and 32 (IQR 27-35), respectively, compared with a score of 37 (IQR 33-42) for the total population. Additionally, the positive rate for depression screening was notably higher among these groups, with rates of 6%, 10% and 18%, respectively, compared with 3% for the overall group.
CONCLUSIONS: In this observational cohort study, we found that severe UI and/or AI 6 months postpartum significantly impact QoL and increase the likelihood of depression, as indicated by PROMs. Our findings emphasise the importance of screening, evaluation and treatment of UI and/or AI to improve the QoL and reduce the risk of depressive disorders for postpartum women.