Postpartum depression (PPD) is one of the most common complications after childbearing. Urinary incontinence (UI) is a frequent symptom during pregnancy and the postnatal period, often being the first time that women suffer from it. The aims of this systematic review and meta-analysis were to synthesize the evidence on the association between UI and PPD and to assess whether this association becomes weaker at 6 months after childbirth.
MEDLINE, Embase, Cochrane Library, Web of Science and PsicINFO were searched from inception to December 26th, 2023.
Cross-sectional and cohort studies addressing the association between UI and PPD.
A pooled odds ratio (OR) and its 95% confidence interval (CI) and 95% prediction intervals were estimated using a DerSimonian and Laird random-effects model for the association between UI and PPD. Subgroup analyses were conducted based on time after delivery (< 6 months or ≥ 6 months). The risk of bias was assessed with the NIH Quality Assessment Tool for Observational Cohort Studies.
Eleven published studies were included in the systematic review and meta-analysis. Overall, the OR for the association between UI and PPD was 1.45 (95% CI: 1.11 to 1.79; 95% prediction interval: 0.49 to 2.40; I2 =65.9%, p=0.001). For the seven cohort studies, the OR was 1.63 (95% CI: 1.35 to 1.91; 95% prediction interval: 1.14 to 2.13; I2 = 11.1%, p = 0.345) and for the four cross-sectional studies the OR was 1.05 (95% CI: 1.04 to 1.05; 95% prediction interval: 1.04 to 1.06; I2 =0.0%, p=0.413). According to the time after delivery, the OR estimates for cohort studies with a postpartum period < 6 months were 1.44 (95% CI: 1.07 to 1.81; prediction interval: 0.63, 2.25; I2 =0.0%, p=0.603) and 1.53 (95% CI: 1.16 to 1.89; prediction interval: 0.41, 2.65; I2 =50.7%, p=0.087) for those with a postpartum period ≥ 6 months.
This systematic review and meta-analysis suggest that UI may be a potential predictor of PPD, so it is important that healthcare professionals offer support and treatment options to women who experience these problems.
American journal of obstetrics and gynecology. 2024 Mar 02 [Epub ahead of print]
Cristina Gallego-Gómez, Eva Rodríguez-Gutiérrez, Ana Torres-Costoso, Vicente Martínez-Vizcaíno, Sandra Martínez-Bustelo, Claudia Andrea Quezada-Bascuñán, Asunción Ferri-Morales
Faculty of Physiotherapy and Nursing. University of Castilla-La Mancha, Toledo, Spain; Physiotherapy Unit, Health Center of Camarena (Toledo), Spain; Toledo Physiotherapy Research Group (GIFTO), University of Castilla La Mancha, Toledo, Spain., Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain. Electronic address: ., Faculty of Physiotherapy and Nursing. University of Castilla-La Mancha, Toledo, Spain; Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain., Health and Social Research Center, University of Castilla-La Mancha, Cuenca, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 3460000 Talca, Chile., Psychosocial Intervention and Functional Rehabilitation Research Group, Faculty of Physiotherapy, University of A Coruña, Spain., Faculty of Physiotherapy and Nursing. University of Castilla-La Mancha, Toledo, Spain.