Influence of COVID-19 pandemic on self-reported urinary incontinence during pregnancy and postpartum: A prospective study

Objective To explore how the COVID-19 pandemic influenced self-reported occurrence and severity of pregnancy-related urinary incontinence (UI) in the maternity pathways of Tuscany, Italy. Methods In this prospective pre-post cohort study, we selected a pre-pandemic (n = 1018) and a post-pandemic (n = 3911) cohorts of women that completed, from the first trimester until 3 months postpartum, three surveys including validated patient-reported outcome measures for UI. Data were obtained from systematic surveys on the maternity pathways of Tuscany from March 2019 to June 2021. We performed panel regression models to explore how UI risk differed between COVID-19 groups. Results UI occurred less frequently and less severely in post-pandemic patients-especially stress/mixed UI in women never performing pelvic floor muscle training (PFMT)-whereas no difference emerged in women performing during-pregnancy PFMT. During COVID-19, obese women had higher risk of UI, whereas women undergoing operative delivery had lower risk. The post-pandemic group reported more severe UI symptoms at the third trimester, but less severe UI postpartum in women suffering from UI during pregnancy. Conclusions During the COVID-19 pandemic, women reported fewer UI symptoms because they might have lacked chances to identify UI symptoms as a result of pandemic-related sedentarism and inactivity. The risk in women performing during-pregnancy PFMT was not increased, but just six of 26 health districts organized remote PFMT sessions, thus revealing limited resilience to the pandemic in Tuscany.

Automated summary

This study aimed to investigate the impact of the COVID-19 pandemic on pregnancy-related urinary incontinence (UI) in the maternity pathways of Tuscany, Italy. The results showed that UI occurred less frequently and less severely in the post-pandemic group, possibly due to a lack of opportunities to identify UI symptoms during the pandemic. The risk of UI was not increased in women who performed pelvic floor muscle training (PFMT) during pregnancy, but there was limited organization of remote PFMT sessions.