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CC BY 4.0 · Rev Bras Ginecol Obstet 2023; 45(06): 303-311
DOI: 10.1055/s-0043-1770087
Original Article
High Risk Pregnancy

Impact of Obesity and Hyperglycemia on Pregnancy-specific Urinary Incontinence

Impacto da obesidade e hiperglicemia na incontinência urinária específica da gravidez
Giovana Vesentini 
1   Perinatal Diabetes Research Center, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil
,
Fernanda Piculo 
1   Perinatal Diabetes Research Center, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil
,
Gabriela Marini 
1   Perinatal Diabetes Research Center, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil
2   Department of Health Sciences, Universidade Sagrado Coração, Bauru, São Paulo, Brazil
,
Angélica Mércia Pascon Barbosa 
1   Perinatal Diabetes Research Center, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil
,
José Eduardo Corrente 
1   Perinatal Diabetes Research Center, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil
3   Department of Biostatistics, Bioscience Institute, Universidade Estadual Paulista, Botucatu, SP, Brazil
,
Marilza Vieira Cunha Rudge 
1   Perinatal Diabetes Research Center, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil
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Abstract

Objective The lack of data on the impact of hyperglycemia and obesity on the prevalence of pregnancy-specific urinary incontinence (PSUI) led us to conduct a cross-sectional study on the prevalence and characteristics of PSUI using validated questionnaires and clinical data.

Methods This cross-sectional study included 539 women with a gestational age of 34 weeks who visited a tertiary university hospital between 2015 and 2018. The main outcome measures were the prevalence of PSUI, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Incontinence Severity Index (ISI) questionnaires. The women were classified into four groups: normoglycemic lean, normoglycemic obese, hyperglycemic lean, and hyperglycemic obese. The differences between groups were tested using descriptive statistics. Associations were estimated using logistic regression analysis and presented as unadjusted and adjusted odds ratios.

Results Prevalence rates of PSUI were no different between groups. However, significant difference in hyperglycemic groups worse scores for severe and very severe PSUI. When adjusted data for confound factors was compared with normoglycemic lean group, the hyperglycemic obese group had significantly higher odds for severe and very severe forms of UI using ICIQ-SF (aOR 3.157; 95% CI 1.308 to 7.263) and ISI (aOR 20.324; 95% CI 2.265 to 182.329) questionnaires and highest perceived impact of PSUI (aOR 4.449; 95% CI 1.591 to 12.442).

Conclusion Our data indicate that obesity and hyperglycemia during pregnancy significantly increase the odds of severe forms and perceived impact of PSUI. Therefore, further effective preventive and curative treatments are greatly needed.

Resumo

Objetivo A falta de dados sobre o impacto da hiperglicemia e obesidade na prevalência de incontinência urinária específica da gravidez (IAPS) nos levou a realizar um estudo transversal sobre a prevalência e características da IAPS usando questionários validados e dados clínicos.

Métodos Este estudo transversal incluiu 539 mulheres com idade gestacional de 34 semanas que visitaram um hospital universitário terciário entre 2015 e 2018. As principais medidas de desfecho foram a prevalência de PSUI, o formulário curto do International Consultation on Incontinence Questionnaire (ICIQ-SF) e os questionários do Incontinence Severity Index (ISI). As mulheres foram classificadas em quatro grupos: magras normoglicêmicas, obesas normoglicêmicas, magras hiperglicêmicas e obesas hiperglicêmicas. As diferenças entre os grupos foram testadas por meio de estatística descritiva. As associações foram estimadas usando análise de regressão logística e apresentadas como odds ratio não ajustadas e ajustadas.

Resultados As taxas de prevalência de PSUI não foram diferentes entre os grupos. No entanto, houve diferença significativa nos grupos hiperglicêmicos com piores escores para PSUI grave e muito grave. Quando os dados ajustados para fatores de confusão foram comparados ao grupo magro normoglicêmico, o grupo obeso hiperglicêmico teve chances significativamente maiores de formas graves e muito graves de IU usando ICIQ-SF (aOR 3,157; IC 95% 1,308 a 7,263) e ISI (aOR 20,324; 95% CI 2,265 a 182,329) questionários e maior impacto percebido de PSUI (aOR 4,449; 95% CI 1,591 a 12,442).

Conclusão Nossos dados indicam que a obesidade e a hiperglicemia durante a gravidez aumentam significativamente as chances de formas graves e o impacto percebido da PSUI. Portanto, tratamentos preventivos e curativos mais eficazes são extremamente necessários.

Keywords

urinary incontinence - pregnancy - diabetes mellitus - maternal obesity

Palavras-chave

incontinencia urinaria - gravidez - diabetes mellitus - obesidade materna

Contributors

All authors were involved in the design and interpretation of the analyses, contributed to the writing of the manuscript, and read and approved the final manuscript.




Publication History

Received: 15 September 2022

Accepted: 17 April 2023

Article published online:
21 July 2023

© 2023. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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