Introduction
Methods
Search strategy
Eligibility criteria
Study selection
Data extraction and risk of bias
Summary measures, statistical analyses and heterogeneity
Results
Study selection
Risk of bias
Authors/year | Country | Sample | Case definition UI | Timing measurement(s) | Questionnaire validation | Mean age (y) (SD; range) a | Parity(Number of children: n (%) | Sample size [response rate (%)] | Trimester of pregnancy n (%) a | UI prevalence n (%) [Incidence: n (%)] | Type of UI n (%) | Risk of bias items b |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Abdullah et al. 2016 [27] | Malaysia | Nulliparous pregnant women in 3rd trimester | UI not specified | 3rd trimester | Questionnaire based on ICIQ-UI-SF (Face-to-face interview by trained personnel) | < 20 y: n = 25 21–30 y: n = 254 > 30 y: n = 27 | – | 306 | 3rd trimester | 105 (34.4) | - SUI: 68 (64.8) - UUI: 7 (6.7) - MUI: 26 (24.8) - Unknown: 4 (1.3) | 2,5,9 |
Adaji et al. 2010 [53] | Nigeria | All pregnant women | UI not specified | All trimesters | ICIQ-UI-SF (illiterate women assisted by trained nurse) | 29.6 (15–42) | - 0: 46 (22.5) - 1–4: 131 (64.2) - > 4: 27 (13.2) | 204 | - 1st: 9 (4.4) - 2nd: 101 (49.8) - 3rd: 93 (45.8) | 43 (21.1) | - SUI: 26 (60.5) - UUI: 11 (25.6) - MUI: 4 (9.3) - Enuresis: 1 (2.3) - Unexplained: 1 (2.3) | 3,5,8,9 |
Balik et al. 2016 [54] | Turkey | - All pregnant women - 28–40 wks gestation Exclusion criteria: - Diabetes mellitus - POP - Renal disease | UI not specified | 3rd trimester | - ICIQ-UI-SF - IIQ-7 - UDI-6 | 29.41 (5.7; 18–44) | - 0: 90 (36) - ≥ 1: 160 (64) | 250 | 3rd trimester \( \overline{\times} \): 35.45 wks (SD 2.98; range 28–40) | 93 (37.2) | - SUI: 39 (41.9) - UUI: 12 (12.9) - MUI: 42 (45.2) | 3,5,7,8,9 |
Bekele et al. 2016 [55] | Ethiopia | - All pregnant women Exclusion criteria: - Severely sick - Kidney or urethral infection - Contra-indication for vaginal palpation | Complaint of any involuntary leakage of urine at least once during current pregnancy. | All trimesters | Questionnaire adapted | 26 (16–40) | - 0: 132 (31.3) - 1–3: 243 (57.6) - ≥ 4: 47 (11.1) | 422 (92.5) | - 1st: 41 (9.7) - 2nd: 101 (23.9) - 3rd: 280 (66.4) | 48 (11.4) | - SUI: 28 (58) - UUI: 6 (12.5) - MUI: 12 (24.5) - Unknown: 2 (5.0) | 6,7,8 |
Beksac et al. 2017 [56] | Turkey | - Nulliparous pregnant women - No UI before pregnancy Exclusion criteria: - Systemic disorders (DM, obesity, hypertension, urinary system problems) - Previous pelvic floor surgery | UI not specified | - 11–14 wks gestation - ± 24 wks gestation - ± 37 wks gestation | UDI-6 | 27.29 (3.73; 19–35) | Nullipara | 61 | - 11–14 wks gestation - ± 24 wks gestation - ± 37 wks gestation | - 11–14 wks: 3 (4.9) - 24 wks: 6 (9.9) - 37 wks: 16 (26.3) | - SUI: 11–14 wks: 2 (3.3), 24 wks: 4 (6.6), 37 wks: 10 (16.4) - UUI: 11–14 wks: 1 (1.6), 24 wks: 2 (3.3), 37 wks: 4 (6.6) - MUI: 11–14 wks: 0, 24 wks: 0, 37 wks: 2(3.3) | 2,3,5,8,9 |
Bø et al. 2012 [57] | Norway | - All pregnant women - < 20 wks gestation - Living in districts - Planning to give birth at one of two study hospitals | UI not specified | 28 ± 2 wks gestation | ICIQ-UI-SF | 29.3 (4.9) | - 0: 351 (46.1) - ≥ 1: 410 (53.9) | 772 (93.8) | \( \overline{\times} \): 28 ± 2 wks gestation | 310 (41.7) | - SUI: 218 (71.0) - UUI: 28 (9.1) - MUI: 36 (11.7) - Missing: 28 (8.2) | 8 |
Brown et al. 2010 [31] | Australia | - Nulliparous pregnant women - ≥ 18 y - ≤ 24 wks gestation | Leakage of urine at least once per month | - ≤ 24 wks gestation - 31 wks gestation | - Validated questionnaire (≤ 24 wks gestation-questionnaire) - 31 wks gestation- computer assisted telephone interviews) - Sandvik questionnaire | - 18–24: n = 213 (14.1%) - 25–29: n = 430 (28.5%) - 30–34: n = 583 (38.7%) - ≥ 35: n = 281 (18.6%) | Nullipara | - ≤ 24 wks gestation: 1507 (22.0) - 31 wks gestation: 1454 | - ≤ 24 wks: \( \overline{\times} \): 15.03 (SD 3.09, range 6–24) - 31 wks: \( \overline{\times} \): 31 (SD 0.03; range 27–38) | - ≤ 24 wks: 256 (17.0) - 31 wks: 813 (55.9) [Incidence: - ≤ 24 wks: 146 (16.4) - 31 wks: 561 (63.2)] | - SUI: ≤ 24 wks: 125 (8.3), 31 wks: 536 (36.9) - UUI: ≤ 24 wks: 38 (2.5), 31 wks: 86 (5.9) - MUI: ≤ 24 wks: 93 (6.2), 31 wks: 191 (13.1) | 8,9 |
Chan et al. 2013 [58] | China | - Nulliparous pregnant women - ≥ 18 y - Singleton pregnancy - Chinese - No UI before pregnancy | Presence of either SUI or UUI | 1st, 2nd, 3rd trimester | PFDI | 30.6 (3.8) | Nullipara | 328 (74.2) | All trimesters: 328 (100) | - 1st: 38 (11.5) - 2nd: 112 (34.1) - 3rd: 134 (41.8) | - SUI: 1st: 30 (9.1), 2nd: 106 (32.35), 3rd: 124 (37.8) - UUI: 1st: 16 (4.9), 2nd: 17 (5.2), 3rd: 47(14.3) - MUI: 1st: 8 (2.4), 2nd: 11 (3.3), 3rd: 34 (10.4) | – |
Daly et al. 2018 [32] | Ireland | - Nulliparous pregnant women - ≥ 18 y - ≤ 24 wks gestation | Reporting any leakage | During pregnancy (< 24 wks) | - Questionnaire, adapted from existing valid questionnaire - Sandvik questionnaire | - 18–24: n = 81 (9.4%) - 25–29: n = 205 (23.8%) - 30–34: n = 357 (41.5%) - 35–39: n = 189 (22.0) - ≥ 40: n = 28 (3.3%) | Nullipara | 860 (46.7) | < 24 wks | 330 (38.7) [Incidence: 120 (21.7)] | - SUI: 147 - UUI: 40 - MUI: 128 Incidence: - SUI: 71 - UUI: 9 - MUI: 33 | 8 |
De Oliveira et al. 2013 [43] | Brazil | - All pregnant women - Singleton pregnancy Exclusion criteria: - Clin. or obst. Interference during pregnancy - UTI or renal inf. Last 4 wks - Neurological diseases - Cognitive deficit - Illiterate women - Premature birth - Absence of prenatal care | Women reporting not having any UI were defined as continent. Women who reported symptoms of incontinence were defined as “incontinent”. | 3rd trimester: last four weeks of pregnancy | - ICIQ-UI-SF (interview) | 27 | - 1: 200 (40.4) - 2–3: 206 (41.6) - ≥ 4: 89 (18.0) | 495 | 3rd trimester | 352 (71%) | – | 5,7,8,9 |
Dinc et al. 2018 [59] | Turkey | - All pregnant women - Any gestational age Exclusion criteria: - 1 UTI - History of urological/ gynaecological surgery | UI not specified | All trimesters | Self-developed questionnaire (face-to-face interviews) | 26.18 (5.07; 17–42) | - 0: 393 (52.4) - 1: 248 (33.1) - > 1: 107 (14.3) - Missing n = 2 | 750 | - 1st: 128 (17.1) - 2nd: 311 (41.45) - 3rd: 311 (41.45) | 300 (40.0) By trimester: 1: 38 (29.7) 2: 100 (32.2) 3: 162 (52.1) | SUI: 241 (80.3) UUI: 12 (4.0) MUI: 47 (15.7) | 5,8,9 |
Dolan et al. 2004 [60] | UK | - Nullipara | Any UI within last 3 months | 34–40 wks gestation | - Self-developed urinary incontinence questionnaire - KHQ - 34–40 wks: interview, other postal | 26 (5.26) | Nullipara | 492 | 34–40 wks | - Antenatal: 175 (35.6) - Pre-pregn: 17 (3.5) | - SUI: antenatal: 75 (49.0) - UUI: antenatal: 4 (2.6) - MUI: antenatal: 74 (48.4) - Unexplained:22 | 6,7,8,9 |
Groutz et al. 1999 [61] | Israel | - Nulliparous, primiparous and grand multiparous women | Stress UI: involuntary leakage of urine with coughing, laughing, sneezing, or any other physical effort | 2nd or 3rd day post-partum | Interview | 20–43 | 0: 100 1: 100 ≥ 5: 100 | 300 | 1–40 wks | 127 (42.3) By parity: - 1: 28 (22.0) - 2: 49 (38.6) - ≥ 5: 50 (39.4) | – | 3,4,5,6,8,9 |
Hansen et al. 2012 [62] | Denmark | - Primipara - ≥ 18 y | Any urinary leakage | UI during pregnancy (last 3 months) | - ICIQ-UI-SF - Interference daily life | 28.2 (4.8) | Nullipara | 1018 (63) | 3rd trimester | 327 (32.1) | - SUI: 243 (23.9) - UUI: 31 (3.0) - MUI: 53 (5.2) | 8 |
Herath et al. 2017 [21] | Sri Lanka | - Nulliparous pregnant women - Second and third trimester Exclusion criteria: - Condition which prohibits physical exercise | UI not specified | 2nd and 3rd trimester | Not validated questionnaire (interviewer-administered questionnaire) | 26.4 (4.4; 18–43) | Nullipara | 1017 | - 2nd trim: 189 (18.6) - 3rd trim: 828 (81.4) | - 192 (18.9) | - SUI: 94 (9.2) - UUI: 79 (7.8) - MUI: 19 (1.9) | 9 |
Højberg et al. 1999 [28] | Denmark | - All pregnant women - 16 wks of gestation | Involuntary loss of urine within the last year | 16 wks of gestation | - Self-developed questionnaire | 15–24: n = 1347 (17%) 25–29: n = 3253 (42%) 30–34: n = 2365 (30%) ≥ 35: n = 830 (11%) | - 0: 4103 (53) - 1: 2643 (34) - 2: 851 (11) - ≥ 3: 198 (2) | 7795 (97) | 16 wks | 693 (8.9) By parity: - 0: 136 (3.9) - 1: 361 (13.8) - ≥ 2: 169 (16.2) | - SUI: 385 (55.2) - UUI: 53 (7.6) - MUI: 185 (26.6) - Unclassified: 17 (0.2) - Missing n = 53 | 8 |
Huebner et al. 2010 [63] | Germany | - Primipara - Singleton pregnancy - Cephalic presentation - Vaginal delivery - Duration of pregnancy ≥ 38 wks gestation | UI not specified | 1st & 2nd half of pregnancy | Self-developed questionnaire | 28.1 (4.7) | Nullipara | 411 (67.4) | – | - 1st half pregnancy: 15 (3.6) - 2nd half pregnancy: 108 (26.3) | – | 5,6,8 |
Hvidman et al. 2002 [20] | Denmark | - Nulli- and primiparous women | UI not specified | During 1st and 2nd pregnancy | - Not validated questionnaire | 28.1 | - 0: 352 (54.9) - 1: 290 (45.1) | 642 (60.3) | - 1st: 27 (4.2) - 2nd: 61 (9.5) - 3rd: 133 (20.7) | - Nulliparous: 70 (19.9) - Primiparous: 72 (24.8) [Incidence: - Nulliparous: 59 (16.8) Primiparous: 24 (8.4)] | – | 5,6,8 |
Jean-Michel et al. 2018 [42] | USA | - Pregnant women ≤ 25 y - Presenting to the labor and delivery triage unit for routine obstetric care or admitted to the maternity ward. Exclusion criteria: - < 12 wks gestation | UI not specified | 3 mths preceding study enrollment | 3IQ | 20.3 (2.6) | - 0: 63 (64) - ≥ 1: 35 (36) | 98 (82.4) | \( \overline{\times} \): 34.5 wks (SD 7.5) - 1st: 1 - 2nd: 18 - 3rd: 79 | 51 (52.0) | - SUI: 32 (63) - UUI: 16 (31) - MUI: 0 - Unclassified: 3 (6) | 3,5,6,8 |
Kocaöz et al. 2010 [64] | Turkey | All pregnant women | UI not specified | - ICIQ-UI-SF - Wagner’s QoL scale (Face-to-face interviews) | 28.1 (1.29) | - 0: 175 (44.5) - 1: 150 (52.3) - 2: 53 (16.5) - 3: 10 (3.4) - ≥ 4: 5 (1.7) | 393 | - 1st: 27 (6.9) - 2nd: 47 (11.9) - 3rd: 319 (81.2) | 106 (26.97) By trimester: - 1st: 3 (11.1) - 2nd: 9 (19.1) - 3rd: 94 (29.5) | - SUI: 58 (54.7) - UUI: 27 (25.5) - MUI: 17 (16.0) - Unclassified: 4 (3.8) | 5,8,9 | |
Kok et al. 2016 [65] | Turkey | - All pregnant women - ≥ 18 y Exclusion criteria: - High risk pregnancy | All responses other than ‘never’ on the questions ‘how often do you leak urine?’ and ‘How much urine do you usually leak?’ | Any gestational age | - ICIQ-UI-SF - I-QoL | 30.2 (4.44) - ≤ 29: n = 129 (44.9%) - ≥ 30: n = 158 (55.1%) | - 0: 112 (39.0) - ≥ 1: 127 (44.3) - Missing: 48 (16.7) | 287 | \( \overline{\times} \): 29.5 wks (SD 8.29) | 61 (21.3) By trimester: - 1st: 2 (3.3) - 2nd: 5 (8.2) - 3rd: 54 (88.2) | - SUI: 44 (72.1) - UUI: 16 (26.1) - MUI: 1 (1.8) | 2,3,7,8,9 |
Liang et al. 2012 [66] | Taiwan | - Nullipara - ≥ 36 wks pregnancy delivered - Singleton pregnancy Exclusion criteria: - Severe cardiopulmonary or renal diseases - Preeclampsia - Insulin dependent DM - Neurogenic diseases - Surgery for POP or UI | Experiencing leakage of urine at least once a month | 2nd or 3rd day post-partum | Liang et al. LUTS questionnaire (face-to-face interview) | 29.4 (4.1) | Nullipara | 1501 | 1st -3rd | 563 (37.5) | - SUI: 1st trim: 147 (9.8), 2nd trim: 208 (13.9), 3rd trim: 400 (26.7) - UUI: 1st trim: 16 (1.1), 2nd trim: 33 (2.2), 3rd trim: 71 (4.7) - MUI: 1st trim: 32 (2.1), 2nd trim: 46 (3.1), 3rd trim: 91 (6.1) | 5,8,9 |
Lin et al. 2018 [8] | Taiwan | - All women delivering after 28 wks gestation Exclusion criteria: - Multiple gestation - Severe cardio-pulmonary or renal diseases - Preeclampsia - Insulin dependent diabetes mellitus - Neurogenic diseases - UI before pregnancy | SUI; losing urine on coughing, sneezing, or physical exertion | During pregnancy | - Interview in obstetric ward - LUTS questionnaire - SF-12 - IIQ-7 - UDI-6 | 32.6 (4.3) | \( \overline{\times} \): 1.7 (SD: 0.7) | 866 | 1st -3rd | 446 (51.5) | – | 8,9 |
Luo et al. 2017 [67] | China | - All pregnant women - Singleton pregnancy Exclusion criteria: - UI before pregnancy - Abdominal and vaginal surgery - DM - Hypertension - Placenta previa - Threatened abortion - Amniotic fluid abnormalities -Foetal growth restriction - Vaginal bleeding Exclusion criteria: - Failure to complete all investigation content and unreliable pelvic ultrasound data | UI not specified | Any gestational age | ICIQ-UI-SF | 30.5 Nullipara: 28.4 (3.8) Para: 32.7 (3.70) | - 0: 179 (52.3) - ≥ 1: 163 (47.7) | 342 | Nullipara: - 1st: 64 (35.8) - 2nd: 60 (33.5) - 3rd: 55 (30.7) Para: - 1st: 58 (35.6) - 2nd: 57 (35.0) - 3rd: 48 (29.4) | 135 (39.5) | – | 3,8,9 |
Mallah et al. 2014 [68] | Iran | - Vaginal delivery - Nullipara - Healthy women Exclusion criteria: - UI before pregnancy - History of pelvic trauma, anus and rectal surgery - Previous urinary/ gastrointestinal tract impairment | UI not specified | 1st - 3rd trimester | - Self-developed questionnaire - VAS severity | 28.1 (3.7, 19–32) | Nullipara | 441 | – | - 1st trim: 44 - 2nd trim: 85 - 3rd trim: 194 | – | 2,5,6,7,8,9 |
Marshall et al. 1998 [69] | UK | All women 2 or 3 days past delivery | UI not specified | 2nd or 3rd day post-partum | Self constructed questionnaire | – | - 0: 3562(45.9) - 2–4: 3826 (49.3) - ≥ 5: 374 (4.8) | 7762 | 1st -3rd | 3570 By parity: - 0: 1755 -2–4: 1683 - ≥ 5: 132 | – | 4,6,8,9 |
Martin-Martin et al. 2014 [70] | Spain | - Pregnant women - Singleton pregnancy Exclusion criteria: - UI before pregnancy | UI not specified | 3rd trimester | - (Modified) ICIQ-UI-SF (questionnaire given end of 3rd trimester) | 31 (5.1) | - 0: 224 (58.8) - ≥ 1: 160 (41.9) | 381 (82.6) | 3rd trimester | 118 (31) | - SUI: 84 (71%) - UUI: 4 (3.4%) - MUI: 25 (21.5%) - Unclassified: 5 (4.3%) | 6,7,8 |
Martinez Franco et al. 2014 [71] | Spain | - Pregnant women - < 13 wks gestation - > 28 wks gestation | UI not specified | 1rd and 3rd trimester | - ICIQ-UI-SF - PFDI-20 | 30.8 (16–42) | - 0: 122 (54.5) - 1: 91 (40.6) - 2: 8 (3.6) - 3: 3 (1.3) | 224 | - 1st: 58 (25.9) - 3rd: 166 (74.1) | 77 (34.4) By trimester: - 1st: 11 (19.0) - 3rd: 66 (39.8) | - SUI: 37 (48) - UUI: 7 (9.1) - MUI: 25 (32.5) - Unclassified: 8 (10.4) | 3,5,8,9 |
Martins et al. 2010 [72] | Brazil | -Pregnant women Exclusion criteria: - High-risk pregnancy - Parents who did not give consent to pregnant women < 18 y - Prenatal care at private clinics | UI regardless of amount- | Any gestational age | - Questionnaire designed and validated for this research (interview) | 24.26 (14–45) | - 0: 248 (49.6) - 1: 133 (26.6) - 2: 67 (13.4) - 3: 32 (6.4) - ≥ 4: 20 (4.0) | 500 (100) | All trimesters | 319 (63.3) | - SUI: 196 (39.2) - UUI: 201 (40.2) | 8 |
Mørkved et al. 1999 [73] | Norway | - All women who delivered at hospital | UI not specified | - Before pregn. - During pregn. | Structured interview 8 wks post-partum | 28 (19–40) | \( \overline{\times} \): 1.8 (1–5) - 1: 52 (36.1) - 2: 54 (37.5) - 3: 31 (21.5) - ≥ 4: 7 (4.9) | 144 (72) | All trimesters | 60 (42) By parity: - 1: 18 (35) - 2: 20 (37) - 3: 17 (55) - ≥ 4: 5 (70) | – | 3,8 |
Nigam et al. 2016 [29] | India | - All pregnant women - > 34 wks pregnancy Exclusion criteria: - High risk pregnancy | UI not specified | 34 wks gestation | - Questionnaire (based on ICIQ-UI-SF) - Interview | - ≤ 20: n = 19 - 21–25: n = 194 - 26–30: n = 162 - 31–35: n = 25 | - 0: 153 (38.25) - ≥ 1: 247 (61.75) | 400 | Late 3rd trim | 301 (75.3) | - SUI: 219 (72.7) - UUI: 16 (4.0) - MUI: 66 (21.9) | 7,8,9 |
Okunola et al. 2018 [25] | Nigeria | - Pregnant women - 18–45 y Exclusion criteria: - DM - UI prior to pregnancy - UTI - Use of parasympathomimmetic or sympatholytic drug - Urological/ gynaecological surgery | UI not specified | Any gestational age | - ICIQ-UI-SF - Illiterate participants were assisted by 2 trained nurses | 29.9 (5.3) | - 0: 150 (33.9) - ≥ 1: 292 (66.1) | 442 (85.5) | - 1st: 12 (2.7) - 2nd: 83 (18.8) - 3rd: 47 (78.5) | 124 (28.1) By parity: - 0: 43 (28.7) - ≥ 1: 81 (27.7) | - SUI: 77 (17.4) - UUI: 30 (6.8) - MUI: 17 (3.9) | 5,8 |
Raza-Khan et al. 2006 [34] | USA | - All pregnant women Exclusion criteria: - Maternal history of preexisting DM - Active cardiac disease excl. Mitral valve prolapse - Neurological disease - Urinary tract surgery - Congenital genito-urinary abnormalities | Any MESA answer of ‘sometimes’ or ‘often’ | 3rd trimester | - MESA - Hunskaar Severity Index | 28 (17–41) | - 0: 37 (32.7) - 1: 47 (41.6) - 2: 18 (15.9) - 3: 10 (8.8) - 4: 1 (0.9) | 113 | 3rd trimester: \( \overline{\times} \): 34.8 (2.6) | 83 (74) | - SUI: 36 (32) - UUI: 4 (4) - MUI: 42 (37) - Unclassified: n = 1 | 3,8,9 |
Rocha et al. 2017 [74] | Portugal | - ≥ 18 y - Singleton pregnancy Exclusion criteria: - (Para)sympatica DM - UI before pregnancy - UTI/ genital infections - Urogynaecological surgery - Actual(this pregnancy)pre-term labor - Foetal death | UI not specified | Directly post-partum | Adapted ICIQ-UI-SF | 29.3 (5.7) | - 0: 108 (45.6) - 1: 126 (53.2) - ≥ 2: 3 (1.3 | 237 | 3rd trimester | 123 | - SUI: 101 (82.1) - UUI: 12 (10) - MUI: 10 (7.9) | 3,8,9 |
Rogers et al. 2017 [75] | USA | - Pregnant > 18 y - Nulliparous - Singleton foetus - No serious medical problem - < 36 wks gestation | UI score > 0 on ISI | 1rd - 3rd trimester | - ISI - QUID - IIQ-7 | 24.2 (5.1) | Nullipara | 623 | - 1st: 124 (19.9) - 2nd: 403 (64.7) - 3rd: 96 (15.4) | - 1st: 40 (33) - 2nd: 176 (44) - 3rd: 407 (69) | SUI - 1st: 10 (25) - 2nd: 60 (34) - 3rd: 135 (34) UUI - 1st: 19 (48) - 2nd: 81 (47) - 3rd: 194 (48) | 2,5,8,9 |
Sharma et al. 2009 [33] | India | - All pregnant women | UI not specified | 1st - 3rd trimester | Questionnaire designed for this study (interview) | 26.5 (18–39) | - 0: 80 (33.3) - 1–3: 133 (55.4) - 4–8: 27 (11.3) | 240 | - 1st: 29 (12.1) - 2nd: 89 (37.8) - 3rd: 122 (50.1) | 62 (25.8) By trimester: - 1st: 7 (24.1) 2nd: 21 (23.6) 3rd: 34 (27.9) | - SUI: 46 (19.2) - UUI: 7 (2.9) - MUI: 9 (3.8) | 2,3,5,7,8 |
Solans-Domènech et al. 2010 [26] | Spain | - Healthy nulliparous pregnant women Exclusion criteria: - UI before pregnancy - Neurological disease - Cognitive disorders - Urological pathology(non infectious) - Abortion - Impaired mobility - Previous urogynaecologic surgery - Current treatment with drugs (benzodiazepines, diuretics) | UI not specified | 1st - 3rd trimester | - ICIQ-UI-SF - ISI | – | Nullipara | 1128 | 1st - 3rd trimester | 441 (39.1) By trimester: - 1st: 84 (8.3) - 2nd: 319 (31.8) - 3rd: 322 (28.5) [Incidence: 441 (39.1) By trimester: - 1st: 84 (8.3) - 2nd: 282 (28.1) - 3rd: 141 (15.2)] | - SUI: 1st trim: 57 (67.9), 2nd trim: 250 (79.8), 3rd trim: 255 (79.2) - UUI: 1st trim: 15 (17.9), 2nd trim: 25 (7.8), 3rd trim: 22 (6.8) - MUI: 1st trim: 3 (3.6), 2nd trim: 20 (6.3), 3rd trim: 18 (5.6) - Unclassified: 1st: 9 (10.7), 2nd trim: 20 (6.3), 3rd trim: 22 (6.8) | 9 |
Sottner et al. 2006 [76] | Czech Republic | Nullipara | UI not specified | 1rd - 3rd trimester (questions asked 2nd day after delivery) | Questionnaire designed for this study | – | Nullipara | 339 (71.5) | All trimesters (each trimester same sample) | - 1st: 56 (16.5) - 2nd: 118 (34.8) - 3rd: 218 (64.3) | - SUI: 177 (52.2) - UUI: 115 (33.9) Before pregnancy: - SUI: 52 (15.3) - UUI: 18 (5.3) | 4,6,8 |
Spellacy et al. 2001 [44] | USA | - Healthy pregnant women - ≥ 18 y | UI not specified | 3rd trimester | Self-developed questionnaire (3rd trim: face to face Interview) | 25.4 (5.34) | 0–4 | 50 | 3rd trimester | 31 (62) | – | 2,3,6,7,8,9 |
Tanawattanacharoen et al. 2013 [45] | Thailand | - Pregnant women Exclusion criteria: - Multiple pregnancy - UI before pregnancy - Urethra/bladder surgery - LUTS and infection during pregnancy - DM - Hypertension with diuretic treatment - Incomplete medical record | UI not specified | ≥ 36 wks gestation | Modified ICIQ-UI-SF | - < 20: n = 17 (4.1%) - 20–29: n = 222 (53.8%) - 30–39: n = 165 (40.0%) - 40–49: n = 9 (2.2%) | - 0: 182 (44.1) - ≥ 1: 231 (55.9) | 413 | ≥ 36 wks | 222 (53.8) | - SUI: 221 (53.5) - UUI: 83 (20.0) - MUI: 82 (19.8) | 6,8,9 |
Thomason et al. 2007 [46] | USA | - Primipara Exclusion criteria: - Genital anomalies - Diabetes with risk of UTI - Prior urinary tract infection/surgery - Pregnant - Delivered by CS - UI before pregnancy | Have you involuntarily lost or leaked any amount of urine? | ≥ 35 wks gestation (questions asked 6–9 months post-partum) | Self-constructed questionnaire | - Primiparous continent: 29.7 - Primiparous incontinent: 29.8 | Nullipara | 121 (75.6) | ≥ 35 wks gestation | 62 (51) | 3,8 | |
Valeton et al. 2011 [77] | Brazil | - Pregnant women - ≥ 28 wks gestation - 14–30 y Exclusion criteria: - UTI/gynaecological infection - Urogynecology surgery - Use of parasympa-thomimetic/sympatholytic drugs - DM - Premature labor in current pregnancy - Foetal death - Delivered infant in another institution | Symptoms of involuntary loss of urine | 3rd trimester | - Self-reported UI - KHQ | 23.2 (3.69) | - 0: 177 (51.6) - 2: 105 (30.6) - ≥ 3: 61 (17.8) | 343 | 3rd trimester | 105 (30.6) By parity: - 0: 89 (26) - 2: 103 (30) - ≥ 3: 151 (44) | 7,8,9 | |
Wesnes et al. 2007 [22] | Norway | All pregnant women | Everybody answering yes on the entry questions regarding UI before or during pregnancy or answering affirmatively about frequency, amount or volume before or during pregnancy, were defined as incontinent. | 30 wks (3rd trimester) | Questionnaire | 29.5 (14–47) | - 0: 19.981 (46.2) - ≥ 1: 23.298 (53.8) | 43.279 (45) | 3rd trimester | 25.121 (58.1) [Incidence: 13.978 (45.6) SUI: 9.634 (31.5) UUI: 1.231 (4.0) MUI: 3.113 (10.2)] | - SUI: 15.961 (36.9) - UUI: 2.083 (4.8) - MUI: 7.077 (16.4) | 8 |
Zhu et al. 2012 [78] | China | - Primipara - ≥ 28 wks gest. | UI not specified | - 37–42 wks gestation | BFLUTS | 26.4 (4.0) | Primiparous | 10.098 | Late pregnancy | 2.696 (26.7) | - SUI: 1.878 (18.6) - UUI: 202 (2.0) - MUI: 434 (4.3) - Other UI: 182 (1.8) | 5,8,9 |
Study characteristics
Measurement instrument | Background information on measurement instrument | Study | Original measurement result (mean) | Trimester/ weeks | (Converted) measurement results (0–100) |
---|---|---|---|---|---|
ICIQ-UI-SF (0–21) | To assess symptoms of UI and impact on QoL. (4 questions, question 4 is on moment of UI and is not within the calculation of the total). | 54 | 4.1 | AT | 19.3 |
58 | 6.3 | (28 wks ± 2 wks) T3 | 30.0 | ||
44 | 12.1 | (last 4 wks pregn) T3 | 57.6 | ||
63 | 6.2 | T3 | 29.5 | ||
73 | 6.6 | (T1 and T3) AT | 31.4 | ||
26, 27 | Results reported in categories. No total score | ||||
ICIQ-UI SF Question 3 (QoL) (0–10) | Question 3 of the ICIQ-UI SF is on the interference in daily life of UI | 69 | Nulliparous 2.7 | AT | 26.7 |
Multiparous 3.6 | AT | 35.8 | |||
3.1 | AT | 31.3 | |||
72 | 3.5 | T3 | 34.8 | ||
I-QOL | Quality of life in persons with UI. 3 subscales: 1. Avoidance and limiting behaviour, 2. Psychosocial impact, 3. Social embarrassment. (22 questions) | 67 | 82.4 | AT | 17.7 |
IIQ | Interference of UI of women’s daily life and the bothersomeness. 4 subscales: 1. Physical activity, 2. Travel, 3. Social relationships, 4. Emotional health. (31 questions) | 77 | 9.5 (T1: 8.2, T2: 7.1, T3: 13.3) | AT (T1, T2, T3) | 9.5 |
Wagner’s quality of life scale | Questions on daily lives and psychosocial characteristics. (28 questions) | 66 | 9.9 | AT | 11.8 |
Self- constructed non-validated questionnaire | 28 |
Synthesis of results
Overall prevalence
Subcategories trimester of pregnancy, type of UI and parity
Subcategories frequency and amount of UI
Bother
Total (all instruments) | ICIQ-UI SF (total score) | ICIQ-question 3 (QoL) | Other measurement instruments (I-Qol, IIQ-7, Wagner’s QoL) | |
---|---|---|---|---|
All trimesters | 9.5–34.1 (7 studies) | 19.3–31.4 (2 studies) | 31.3 (1 study) | 9.5–34.1 (3 studies) |
3rd trimester | 13.3–57.6 (5 studies) | 29.5–57.6 (3 studies) | 34.8 (1 study) | 13.3 (1 study) |