Urinary incontinence (UI) is a frequent yet often underrecognized morbidity among postpartum women. Understanding its prevalence, trajectory, and risk factors is essential for informing preventive and management strategies. This study aimed to investigate the prevalence and progression of UI across four postpartum periods-first week (M1), first month (M2), first year (M3), and third year (M4)-and to identify predictors associated with UI persistence at three years postpartum.
A prospective longitudinal cohort study was conducted including 139 women who completed the validated Portuguese version of the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Data were collected at M1, M4, and at least one intermediate time point (M2 or M3). Descriptive statistics and logistic regression analyses were performed to assess prevalence patterns, symptom severity, and predictors of long-term UI.
UI prevalence was highest at M1 (51.1%), declined at M2 (23.0%), increased again at M3 (41.2%), and stabilized at M4 (38.1%). Stress urinary incontinence was the predominant subtype across all time points. Symptom severity tended to progress from mild-moderate (M1-M2) to moderate-severe (M3-M4) among women with persistent symptoms. Higher body mass index (BMI) and gestational duration ≥ 39 weeks were independently associated with long-term UI, increasing the odds by approximately 13% per BMI unit and 3.7-fold, respectively.
Persistent urinary incontinence remains relatively common up to three years postpartum, particularly among women with higher body mass index and longer gestational duration. Early postpartum screening may help identify women at increased risk of persistent symptoms, although the impact of specific therapeutic interventions was not assessed in this study. Promoting pelvic floor health awareness together with weight-management counselling within routine postpartum care may inform preventive strategies for postpartum continence care, although further interventional studies are required to confirm effectiveness.
World journal of urology. 2026 Jun 23*** epublish ***
Ana Sofia Carneiro, Sara Gabriela Amorim, Ana Rita Morais, Sara de Melo Correia, Pedro Oliveira, Vanessa Silva
Department of Obstetrics and Gynaecology, Unidade Local de Saúde do Alto Ave (ULSAAVE), Guimarães, Portugal. ., School of Health Sciences, University of Minho, Braga, Portugal., Department of Obstetrics and Gynaecology, Unidade Local de Saúde do Alto Ave (ULSAAVE), Guimarães, Portugal.