Urinary incontinence linked to postpartum depression

The risk of postpartum depression (PPD) appears to increase by as much as 45 percent in the presence of urinary incontinence, according to the results of a meta-analysis.

Researchers searched multiple online databases for cross-sectional and cohort studies wherein the association between urinary incontinence and PPD was assessed. They initially identified 465 studies, out of which seven cohort studies and four cross-sectional studies met the eligibility criteria and were included in the meta-analysis.

The total study population comprised 92,974 participants, with the maternal age ranging between 15 and 40 years. The most frequent type of delivery was spontaneous vaginal delivery, with the number of deliveries ranging from 1 to 5.

Pooled data showed that urinary incontinence was associated with greater odds of PPD (odds ratio [OR], 1.45, 95 percent confidence interval [CI], 1.11–1.79; 95 percent prediction interval [PI], 0.49–2.40; I²=65.9 percent; p=0.001).

Across the seven cohort studies, the OR for PPD associated with urinary incontinence was 1.63 (95 percent CI, 1.35–1.91; 95 percent PI, 1.14–2.13; I²=11.1 percent; p=0.345). Across the four cross-sectional studies, the OR was 1.05, 95 percent CI, 1.04–1.05; 95 percent PI, 1.04–1.06; I²=0.0 percent; p=0.413).

In subgroup analyses conducted on the basis of time after delivery (<6 or ≥6 months), the OR for PPD associated with urinary incontinence was 1.44 (95 percent CI, 1.07–1.81; 95 percent PI, 0.63–2.25; I²=0.0 percent; p=0.603) across cohort studies with a postpartum period <6 months and was 1.53 (95 percent CI, 1.16–1.89; 95 percent PI, 0.41–2.65; I²=50.7 percent; p=0.087) across studies with a postpartum period ≥6 months.

The findings suggest that urinary incontinence may predict PPD, highlighting the importance of offering support and treatment options to women with urinary incontinence and depression in the postpartum period, according to the researchers.