Women’s pelvic floor muscle strength and urinary and anal incontinence after childbirth: a cross-sectional study<sup/>

Zizzi, Priscila Tavares; Trevisan, Karina Fernandes; Leister, Nathalie; Cruz, Camila da Silva; Riesco, Maria Luiza Gonzalez

doi:10.1590/S1980-220X2016209903214

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Revista da Escola de Enfermagem da USP

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 51 • 2017 • https://doi.org/10.1590/S1980-220X2016209903214 copy

Women’s pelvic floor muscle strength and urinary and anal incontinence after childbirth: a cross-sectional study^* * Extracted from the dissertation “Força muscular perineal e incontinência urinária e anal em mulheres após o parto: estudo transversal”, Escola de Enfermagem, Universidade de São Paulo, 2015.

Fuerza muscular perineal e incontinencia urinaria y anal en mujeres después del parto: estudio transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE

To analyse pelvic floor muscle strength (PFMS) and urinary and anal incontinence (UI and AI) in the postpartum period.

METHOD

Cross-sectional study carried out with women in their first seven months after child birth. Data were collected through interviews, perineometry (Peritron™), and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF).

RESULTS

128 women participated in the study. The PFMS mean was 33.1 (SD=16.0) cmH₂O and the prevalence of UI and AI was 7.8% and 5.5%, respectively. In the multiple analyses, the variables associated with PFMS were type of birth and cohabitation with a partner. Newborn’s weight, previous pregnancy, UI during pregnancy, and sexual activity showed an association with UI after child birth. Only AI prior to pregnancy was associated with AI after childbirth.

CONCLUSION

Vaginal birth predisposes to the reduction of PFMS, and caesarean section had a protective effect to its reduction. The occurrence of UI during pregnancy is a predictor of UI after childbirth, and women with previous pregnancies and newborns with higher weights are more likely to have UI after childbirth.AI prior to pregnancy is the only risk factor for its occurrence after childbirth. Associations between PFMS and cohabitation with a partner, and between UI and sexual activity do not make possible to conclude that these variables are directly associated.

Descriptors
Urinary Incontinence; Fecal Incontinence; Postpartum Period; Muscle Strength; Obstetric Nursing

Variable	UI after childbirth
	Yes		No		Total
	N	%	N	%	N	%
UI only prior to pregnancy	1	0.8	15	11.7	16	12.5
UI only during pregnancy	3	2.3	29	22.7	32	25.0
UI prior to pregnancy and during pregnancy	6	4.7	25	19.5	31	24.2
Without UI prior to pregnancy or during pregnancy	-	-	49	38.3	49	38.3
Total	10	7.8	118	92.2	128	100

Variable	AI after childbirth
	Yes		No		Total
	N	%	N	%	N	%
AI only prior to pregnancy	2	1.6	15	11.7	17	13.3
AI only during pregnancy	1	0.7	9	7.0	10	7.8
AI prior to pregnancy and during pregnancy	2	1.6	14	11.0	16	12.5
Without AI prior to pregnancy or during pregnancy	2	1.6	83	64.8	85	66.4
Total	7	5.5	121	94.5	128	100

Variable	Final model^* * Linear regression;
Variable	Coefficient	95% CI	P-value^† † Student’s t-test.
Cohabitation time (years)
<1	11.61	2.29 to 20.92	0.015
1├─┤5	1.42	−5.74 to 8.58
> 5	0
Previous caesarean section
Yes	10.36	1.45 to 19.26	0.023
No	0
Present type of birth
Vaginal birth	−8.92	−16.71 to−1.14	0.025
Caesarean section	0

Variable	Final model^* * Logistic regression;
Variable	OR	95% CI	P-value^† † Wald test.
Weight of the presentNB(per 10g)	1.03	1.0006-1.0518	0.045
Previous pregnancy
Yes	13.14	1.63-106.27	0.016
No	1
UI during pregnancy
Yes	20.43	1.70-244.98	0.017
No	1
Sexual activityafter childbirth
Yes	0.06	0.01-0.49	0.008
No	1

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author
Maria Luiza Gonzalez Riesco. Av. Dr. Enéas de Carvalo Aguiar, 419. CEP 05403-000 - São Paulo, SP, Brazil. riesco@usp.br