Urinary Incontinence and Anxiety in Pregnancy
Condition: Anxiety in Pregnancy (Disorder); Urinary Incontinence; Quality of Life
MeSH terms: Urinary Incontinence; Enuresis; Anxiety Disorders
Study type: Observational

Summary: 
      This prospective case-control study aimed to evaluate the impact of presence, and severity of
      urinary incontinence (UI) on pregnancy related anxiety. The study included 160 pregnant women
      with uncomplicated pregnancies at the second trimester. The pregnant women with UI (n=80)
      were compared to the control group including continent pregnant women (n=80) in terms of
      Pregnancy-Related Anxiety Scores (PRAQ-R2) and Incontinence Consultation Questionnaire-Short
      Form (ICIQ-SF) in pregnant women. Pelvic Organ Prolapse Questionnaire (POP-Q) was considered
      for the diagnosis of pelvic organ prolapsus. The UI was also divided into subgroups as stress
      (SUI), urge (UUI), and mixed (MUI) types and they were also compared to the control group.
    

Detailed description: 
      In this study, we aimed to evaluate the impact of the presence and the severity of UI on
      pregnancy related anxiety status in a well-defined pregnant cohort. The correlations were
      also analyzed in terms of the UI subtypes as stress urinary incontinence (SUI), urge urinary
      incontinence (UUI) and mixed urinary incontinence (MUI). A total of 160 pregnant women
      applied to outpatient clinics of Obstetrics and Urology Departments were included in the
      current study. Patients were compared in two groups in terms of Study group including
      pregnant women who were diagnosed with the UI (n=80) and Control group including healthy
      pregnant women (n=80). The study was approved by the institutional review board of Ankara
      Training and Research Hospital (# 0067/2019). All the participants were informed, and written
      consent was obtained before the participated the study.

      Physical examination was performed to diagnose the pelvic organ prolapse and the findings
      were classified through the five categories based on Pelvic Organ Prolapse Quantification
      (POP-Q). According to POP-Q, only the pregnant women diagnosed with category 0 or category 1
      were included in the study. All the pregnant women included in the current study were married
      and multiparous women, at the second trimester of the pregnancy, with uncomplicated
      pregnancies and regular pregnancy follow-up. Pregnancies complicated by chronic maternal
      diseases (rheumatological diseases, renal failure, vascular malformations, hypertension,
      cardiac disease, diabetes mellitus, obesity, hypo-hyperthyroidy, congenital hematological
      disorders), acute inflammatory conditions (acute pancreatitis, acute appendicitis), pregnancy
      complications (gestational diabetes, preeclampsia, preterm labor, preterm premature rupture
      of membranes), history of alcohol consumption, having multiple pregnancies, psychiatric
      diseases, cognitive disorders, neurogenic bladder, fecal incontinence, chronic constipation,
      chronic cough, urinary infection, history of pelvic surgery including incontinence surgeries
      and/or taking medication for UI were excluded from the current study. Pregnancy-Related
      Anxiety Questionnaire-Revised (PRAQ-R2) scale was used to evaluate the anxiety status of the
      participants. The International Consultation of Incontinence Questionnaire - Short Form
      (ICIQ-SF) which has been defined by Hajebrahimi et al. as a reliable scale, and validated in
      Turkish by Demircan et al. was used for the evaluation of UI. This scale includes questions
      about the frequency of UI, the conditions at which UI occurs and how much it affects the
      social life of the person. UI subtypes were diagnosed according to the definitions of the
      International Continence Society.
    

Intervention name(s): Gynecological examination; Pelvic Organ Prolapse Quantification (POP-Q); Incontinence Consultation Questionnaire-Short Form (ICIQ-SF) questionnaire; Pregnancy-Related Anxiety Questionnaire-Revised 2 (PRAQ-R2) questionnaire
Intervention type(s): Diagnostic Test; Other; Other; Other
Intervention description(s): Gynecological examination was performed to the whole pregnant cohort included in the study to diagnose either the pelvic organ prolapse according to the POP-Q system or to be sure that they have no findings of pelvic organ prolapse.; Gynecological examination was performed to the whole pregnant cohort included in the study to diagnose either the pelvic organ prolapse according to the POP-Q system or to be sure that they have no findings of pelvic organ prolapse.; ICIQ-SF questionnaire was applied to the Study group to determine the severity of urinary incontinence.; PRAQ-R2 questionnaire was applied to the whole pregnant cohort included in the study to determine their anxiety status.
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Study group: The pregnant women who were diagnosed with the urinary incontinence (n=80)
        with category 0 or category 1 Pelvic Organ Prolapse Quantification (POP-Q) score in
        physical examination.

        Control group: Consisted of healthy women with uncomplicated pregnancies (n=80). They had
        no complaint of urinary incontinence and their gynecological examination did not reveal any
        finding of pelvic organ prolapse.

        The pregnant women included both in the Study and Control group were married and
        multiparous women, at the second trimester of the pregnancy, with uncomplicated pregnancies
        and regular pregnancy follow-up.