Incidence and Impact of Urinary Incontinence, Morbidities, and Health Related Quality of Life for Postpartum Bangladeshi Women: Comparison by Birth Mode
Walton L, Ummal Ambia SJM, Schbley B (2014). Incidence and Impact of Urinary Incontinence and Comorbidity on Health Related Quality of Life for Bangladeshi Women: Comparison by Birth Mode. International Journal of Maternal and Child Health, 2(2), 86-100.
15 Pages Posted: 14 Apr 2013 Last revised: 1 Sep 2014
Date Written: April 12, 2013
Purpose/Hypothesis: To investigate the incidence of urinary incontinence (UI) and relationship between UI, comorbidity, and health related quality of life (HRQOL) of postpartum Bangladeshi women. Comorbidity, and health related quality of life (HRQOL) of postpartum Bangladeshi women.
Number of Subjects: n=94
Materials/Methods: Prospective, correlational design (n=94) postpartum Bangladeshi women, ages 18-44, with history of one or more obstetrical deliveries within the last three years. This study was implemented at the Center for Rehabilitation of the Paralyzed (CRP) in Bangladesh after approval of CRP Ethics Board and IRB approval at Nova Southeastern University. Subjects who met the inclusion criteria for the study and signed the written consent were included in the study and completed the Bengali version of SF-36 and IIQ-7.
Results: Six subjects were eliminated from the study because of co-morbidity exclusion factors. Eight subjects were excluded from main data analysis and utilized for comparison because of “mixed birth mode” (MBM). UI incidence was reported at 45.3% (n=86) total, 44% CS, and 46.6% for NVD (CS: n=41; NVD: n=45). IIQ-7 scores and UI presence showed strong correlations in both CS (rho=.729, 84, p<.001) and NVD (rho=.874, 84, p<.001). The highest impact of UI was reported in the CS group. One sample t-test reported significant differences for the sample when compared with the age equivalent means at alpha=.05-.001. Women in the 35-44 age group reported higher UI incidence and decreased HRQOL scores on the SF-36 and IIQ-7. Significant differences in HRQOL were reported for women with “pelvic/abdominal pain” and “UI” compared to those without “pain” or without “UI” and strong inverse correlations (rho=.597-.853) were reported for subjects with “pain” on the SF-36 domains at alpha=.001. The MBD group (n=8) reported UI incidence at 74%, and pelvic/abdominal pain at 62.5%.
Conclusions: No significant difference between birth modes was found in UI and HRQOL measures. A significant decrease in HRQOL for women during postpartum period compared to age related norms was reported. Report of abdominal/pelvic pain and presence of UI were directly related to HRQOL in this study. Future research should focus on pelvic/abdominal pain in the postpartum period and “mixed birth mode” impact on QOL and UI.
Clinical Relevance: There are no studies comparing HRQOL with incidence and impact of UI and comorbidities amongst Bangladeshi women by birth mode. Postpartum UI and co-morbidities are physical therapy related disorders that are commonly seen in the clinic and have a direct impact on health related quality of life for women.
Keywords: urinary incontinence, maternal mortality, Bangladesh, health access, morbidity, women's health
Suggested Citation: Suggested Citation