Urinary Incontinence Increase Risk of Postpartum Depression: Study

A recent systematic review and meta-analysis published in the American Journal of Obstetrics and Gynecology highlighted that urinary incontinence could elevate the risk of Postpartum depression (PPD). This study analyzed the association between urinary incontinence during pregnancy and the postnatal period with the onset of postpartum depression, also examining whether this link weakens 6 months after childbirth.

This research was conducted as an extensive review of relevant literature after searching databases such as MEDLINE, Embase, Cochrane Library, Web of Science, and PsycINFO. The search spanned from the inception of these databases until December 26, 2023. To ensure a robust analysis, the study included both cross-sectional and cohort studies that explored the connection between urinary incontinence and PPD.

A total of 11 studies were included in the meta-analysis where the pooled data revealed a marked association between urinary incontinence and an increased risk of PPD. The overall odds ratio (OR) for this association was 1.45, with a 95% confidence interval (CI) ranging from 1.11 to 1.79. This indicated that women facing urinary incontinence are 45% more likely to develop postpartum depression when compared to the individuals who do not have this condition.

The analysis also revealed differences in the strength of this association based on the type of study. The 7 cohort studies included in the review showed a higher odds ratio of 1.63, with a narrower confidence interval (1.35–1.91) by suggesting a more consistent link in studies that follow participants over time. Also, the 4 cross-sectional studies which provide a snapshot at a single point in time showed a lower odds ratio of 1.05. Despite being significant, this suggests that the timing and duration of the observation may impact the strength of the association.

The study found the evaluation of whether the association between urinary incontinence and PPD changes over time. The study was conducted as a subgroup analyses based on the time since delivery by categorizing the studies into the individuals with a postpartum period of less than six months and those with a period of six months or more.

For studies with a postpartum period of fewer than six months, the odds ratio was 1.44 which indicated a strong association early in the postpartum period. The association remained significant but slightly increased for studies with a postpartum period of 6 months or more, with an odds ratio of 1.53. This suggests that the risk of postpartum depression associated with urinary incontinence persists and may even intensify beyond the initial postpartum period.

Overall, the findings of this study illuminate the importance of recognizing urinary incontinence as a potential predictor of postpartum depression. Physicians should be careful in identifying and addressing urinary incontinence in postpartum women by offering appropriate support and treatment options.

Source:

Gallego-Gómez, C., Rodríguez-Gutiérrez, E., Torres-Costoso, A., Martínez-Vizcaíno, V., Martínez-Bustelo, S., Quezada-Bascuñán, C. A., & Ferri-Morales, A. (2024). Urinary incontinence increases risk of postpartum depression: systematic review and meta-analysis. In American Journal of Obstetrics and Gynecology (Vol. 231, Issue 3, pp. 296-307.e11). Elsevier BV. https://doi.org/10.1016/j.ajog.2024.02.307