Urinary incontinence: Surprise risk factor for postpartum depression

Postpartum depression is almost twice as likely to occur in women who develop urinary incontinence after delivery than continent women, according to investigators from McMaster University, Hamilton, Ontario, Canada.

The prospective cohort study evaluated 1,897 women, 16 years of age and older, by telephone interview and labor and delivery records to explore the relationship between mode of delivery and postpartum depression at 6 weeks after discharge from hospital. All of the women had delivered singleton live infants at term. Approximately one-third had cesarean deliveries.

At 6 weeks after discharge, almost 8% of the women had postpartum depression as indicated by a score of 12 or higher on the Edinburgh Postnatal Depression Scale. Although mode of delivery wasn’t independently associated with postpartum depression, researchers found other strong predictors, including urinary incontinence. Incontinence almost doubled the risk of depression (odds ratio [OR], 1.79; 95% confidence interval [CI], 1.06-3.03).

In addition to incontinence, the strongest predictors of postpartum depression were maternal age younger than 25 years (OR, 5.27; 95% CI, 2.73-10.15); readmission of the mother to the hospital (OR, 3.02; 95% CI, 1.46-6.24); noninitiation of breastfeeding (OR, 2.02; 95% CI, 0.99-4.11); and good, fair, or poor self-reported postpartum health (OR, 1.82; 95% CI, 1.19-2.80). Other strong predictors included multiparity, low mental health functioning, low subjective social status, high number of unmet learning needs in hospital, low social support, and low physical health functioning.

The study was published in BJOG: The British Journal of Obstetrics and Gynaecology (2011;118[8]:966-967).