Prevalence of Stress, Anxiety and Depression in Overweight Females with Persistent Urinary Incontinence During gestation (28 Weeks Onward) in Karachi

ABSTRACT: INTRODUCTION: Urinary incontinence (UI) is a highly prevalent problem among women world widely and is defined by International Incontinence Society as “involuntary leakage of urine” which leads to compromise on hygiene, social discomfort and limits interaction with others. In Asia 2018 results suggested that almost 423 million 21% women were experienced UI creating one of the most serious provincial burdens. Pregnant women are more susceptible to UI due to structural and physiological changes occur during pregnancy. Research reported as greater than 50% of pregnant women were experienced UI in third trimester with prevalence rate of 34%. Main types of UI were Stress UI, Urge UI, Mixed UI most common was Stress UI. Overweight women experienced UI more commonly than normal weight. UI in women creates a great impact on quality of life (QOL), physical health and sexual life. The embarrassment created by UI that leads to developed psychosomatic consequences such as stress anxiety and depression among women. OBJECTIVE: The aim of this study is to find out the Prevalence of Stress, Anxiety and Depression in Overweight Females with Persistent Urinary Incontinence During gestation (28 Weeks Onward) in Karachi. STUDY DESIGN: Cross Sectional Study design was used in this study. STUDY SETTING: Research was conducted at Gynecological and obstetric OPD at Jinnah Postgraduate Medical Centre (JPMC), Rafah-e-Aam Medical Center, Karach, to show the generalizability of data collection. SUBJECTS AND METHODS: The study design was observational and the calculated sample size was n=154. The Probability Simple Random Sampling technique was used in this study. Initial assessment based on pre- structured proforma. All the participants were taken consent. Every participant was given the right to withdraw any time during the study and data was collected at Rafah E Aam medical ficentre, Brotheran E Allahbad Health Facility, Gyneacology OPD of Jinnah Post Graduate Medical Centre, Karachi. Female participants were according to the inclusion criteria and enrolled with the history of normal vaginal delivery, aged were selected 18-40 years, female participants with no history of trauma and residing in Karachi. Participants were asked to provide their consent. Urinary Incontinence was assessed by Urinary Distress Inventory Short Form (UDI-6) and International Consultation on Incontinence Questionnaire- Urinary Incontinence Short Form (ICIQ-UISF), Depression, Anxiety and Stress was measured by DASS-21. RESULTS: Fisher’s exact test was applied and analyzed the result. The study results showed that 37% mild urine leakage was reported, 51.9% with moderate leakage of urine and 4.5% with severe leakage of urine. In Urinary incontinent patients 21.4% mild stress reported, 39.0% moderate, 22.7% severe and 7.8% extremely severe stress was reported, 1.9% were with mild anxiety, 14.9% moderate, 16.2% severe and 63% were found with extremely severe anxiety levels. There were 7.8% were reported with mild depression, 45.5% moderate, 18.8% severe and 15.6% with extremely severe depression. The P-value less than 0.05 suggested that there was considered statistically significant, CONCLUSION: Urinary Incontinence is a highly prevalent problem among pregnant females in Pakistan. UI creates a significant impact on QOL with severe effects in sexual life. The results of this study concluded that the prevalence of UI among third trimester pregnant women was high and almost half of the subjects were having moderate UI. Finding of this research exposed the facts and figures of psychosomatic illness which is related to the UI according to the results there was severe anxiety of 63% and 18.8% of severe depression and 39% with the moderate stress. KEYWORDS: Urinary Incontinence, Pregnancy, Overweight, Depression, Stress, Anxiety, Quality of Life.