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Predictive factors for time to cessation of urinary incontinence in primiparous adolescents after vaginal delivery
Author(s) -
Babini Dominique,
Lemos Andrea
Publication year - 2020
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.13176
Subject(s) - medicine , vaginal delivery , episiotomy , hazard ratio , urinary incontinence , confidence interval , obstetrics , proportional hazards model , cohort study , cohort , pregnancy , gynecology , surgery , genetics , biology
Objective To investigate predictive factors for the time to cessation of urinary incontinence (UI) and estimate the median time for its cessation in primiparous adolescents after vaginal delivery. Methods A cohort study with 102 adolescents aged 10–19 years with UI after vaginal delivery was developed in the Physical Therapy Laboratory for Women’s Health and Pelvic Floor at the Federal University of Pernambuco between June 2017 and December 2019. Participants responded to the assessment form, providing information on the outcome of interest and possible predictive factors. For statistical analysis, the Cox regression model and the Kaplan–Meier method were used. Results Risk factors identified for the outcome of interest were: age 15–19 years (adjusted hazard ratio [HR a ] 1.37, 95% confidence interval [CI] 0.11–2.8); non‐instrumental delivery (HR a 2.95. 95% CI 1.19–7.53); adoption of vertical position during the expulsion stage of delivery (HR a 2.19, 95% CI 1.28–3.84); and absence of episiotomy (HR a 2.01, 95% CI 1.2–3.44). The median time to cessation of UI was 16 months (10–29). Conclusion Health professionals should reflect on obstetric practices adopted during delivery in adolescents, especially among 10–14‐year‐olds, regarding the use of episiotomy, instrumental delivery, and parturient position during the expulsion stage of delivery.