Factors Associated with Urinary Incontinence During Pregnancy: Clinical, Obstetric, and Metabolic Analysis

INTRODUCTION AND HYPOTHESIS: In addition to biomechanical changes, metabolic alterations, such as gestational diabetes mellitus (GDM), may contribute to the development of pelvic floor dysfunction, such as urinary incontinence (UI). Despite the high prevalence of UI during pregnancy, important gaps in the literature still exist. Thus, the objective of this study was to evaluate the association between clinical, obstetric, and metabolic factors and the presence of UI in pregnant women. METHODS: A cross-sectional study was conducted with a sample of 417 high-risk pregnant women. The volunteers were divided into a group of women with GDM (G-GDM: n = 217) and pregnant women without GDM (G-ND: n = 200). The presence and severity of UI were evaluated using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). Clinical, obstetric, and metabolic variables were analyzed by multiple logistic regression, statistical significance was set at 5% (p < 0.05). RESULTS: No significant differences were observed between the groups regarding the frequency and severity of UI (p = 0.36). Multiparity was the only independently associated predictor of UI, indicating that each additional pregnancy increases the probability of occurrence by approximately 20% (OR 1.20; 95% CI 1.03-1.41; p = 0.02). GDM was not significantly associated with UI (OR 1.46; 95% CI 0.96-2.25; p = 0.08). CONCLUSION: The findings suggest that the biomechanical changes resulting from successive pregnancies appear to be more strongly associated with UI than the influence of GDM. Screening, prevention, and treatment strategies for UI should prioritize multiparous women, aiming to preserve pelvic floor function.