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Hormonal Influence in Stress Urinary Incontinence During Pregnancy and Postpartum

  • General Gynecology: Original Article
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Abstract

Hormonal changes have been proposed as an etiological factor of stress urinary incontinence (SUI) during pregnancy. Our main objective was to demonstrate the role of hormones in SUI development during pregnancy and postpartum. A prospective longitudinal study was designed. Primiparous women without previous urinary incontinence symptoms were included. Symptoms and Quality of Life (QoL) Questionnaires, physical examinations, and hormone concentration (progesterone, estradiol, and relaxin) were collected twice during pregnancy and three times during postpartum. Logistic regression models, with Wald’s forward variable selection method, were used. Prevalence of SUI was 11% in the first trimester, 50% in the third trimester, and 16.4% at 6 months postpartum. The risk of developing SUI throughout pregnancy is higher in women with higher progesterone concentration in the first trimester (OR 1.38, 95% CI 1.06–1.81, p < 0.05) and it is lower in women with stronger pelvic floor muscles in the first trimester (OR 0.35, 95% CI 0.17–0.72, p < 0.05). When occurred during pregnancy, SUI has a 14-fold higher risk of persistence 6 months after birth. In addition, the severity of these symptoms is also an independent risk factor for SUI persistence at 6 months postpartum (OR 1.41, 95% CI 1.15–1.73, p < 0.05). Quality of Life was affected for pregnant women with SUI symptoms. SUI is a highly prevalent condition during pregnancy, affecting the QoL of women in many areas. Higher concentration of progesterone can play a role in SUI development during pregnancy. The presence and severity of SUI during pregnancy are risk factors for the persistence of symptoms 6 months postpartum. Sustaining an optimal pelvic floor muscle strength could prevent SUI during pregnancy.

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Data Availability

The data and material that support the findings of this commentary are available from the corresponding author upon request.

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Acknowledgements

We would like to thank Ms. Emma Herrero for her contribution in patient recruitment and schedule and Ms. Erika Bokor for the English language correction.

Funding

The study was granted funding by the Instituto de Salud Carlos III (ISCIII) (PI13/00623).

Author information

Author notes

  1. Cristina Molinet Coll and Eva Martínez Franco contributed equally in the article.

Authors and Affiliations

  1. Gynecology and Obstetrics Department, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona (UB), C/Antoni Pujadas num 42, 08830, Sant Boi de Llobregat, Barcelona, Spain

    Cristina Molinet Coll & Eva Martínez Franco

  2. Chemistry Laboratory, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Universitat de Barcelona (UB), Barcelona, Spain

    Laura Altimira Queral

  3. Statistical Advising Service, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain

    Daniel Cuadras

  4. Gynecology and Obstetrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona (UB), Barcelona, Spain

    Lluís Amat Tardiu

  5. Colorectal Surgery Unit, Department of Surgery, Hospital Germans Trias I Pujol, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain

    David Parés

Authors
  1. Cristina Molinet Coll
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  2. Eva Martínez Franco
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  4. Daniel Cuadras
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  5. Lluís Amat Tardiu
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  6. David Parés
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Contributions

C. Molinet Coll: data evaluation and manuscript writing. E. Martínez Franco: project development, data collection, and manuscript writing. L. Altimira Queral: blood sample preparation and analysis. D. Cuadras: statistical analysis and interpretation of results. L. Amat Tardiu: protocol development and manuscript edition. D. Parés: project and protocol development.

Corresponding author

Correspondence to Eva Martínez Franco.

Ethics declarations

Ethics Approval

The study was approved by the research and ethical committee of the Fundació de Recerca Sant Joan de Déu (CEImART-03–20).

Consent to Participate

All participants were informed of the nature and objectives of the study through a specific document and signed an informed consent form.

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Not applicable.

Conflict of Interest

The authors declare no competing interests.

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Molinet Coll, C., Martínez Franco, E., Altimira Queral, L. et al. Hormonal Influence in Stress Urinary Incontinence During Pregnancy and Postpartum. Reprod. Sci. 29, 2190–2199 (2022). https://doi.org/10.1007/s43032-022-00946-7

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  • DOI: https://doi.org/10.1007/s43032-022-00946-7

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