Prevalence of postpartum urinary incontinence: a systematic review

Objective. To investigate the prevalence of urinary incontinence within the first year postpartum. Design. A systematic review of population-based studies. Population. General female populations up to 1 year postpartum. Methods. Studies on incontinence in population-based sample defined as from one or more district hospitals or from multiple clinics covering a defined geographic area. Studies of women from a single outpatient clinic or who were referred for care (e. g. for being high risk) were excluded. In addition, studies had to have a sample size of over 100 participants and a response rate 50% or over. Main outcome measures. Prevalence from individual studies as well as mean prevalence is given. Pooled prevalence is estimated for non-heterogenous studies. Results. During the first 3 months postpartum, the pooled prevalence of any postpartum incontinence was 33% (95% confidence interval (CI) 32-36%) in all women. The mean prevalence of weekly and daily incontinence was 12% (95% CI 11-13%) and 3% (95% CI 3-4%), respectively. The mean prevalence was double in the vaginal delivery group (31%, 95% CI 30-33%) compared to the cesarean section group (15%, 95% CI 11-18%). Longitudinal studies within the first year postpartum showed small changes in prevalence over time. Conclusions. The prevalence of postpartum incontinence was high. Prevalence was substantially less for more frequent incontinence. Urinary incontinence after cesarean section was half the prevalence after vaginal delivery.