The literature demonstrates a consistent link between prenatal factors and the risk of developing SUI.
Prognostic Risk Factors
Overall, the literature supports the assumption that pelvic floor dysfunction and stress-urinary incontinence are undeniably attached to childbearing, but a primary risk is pregnancy because cesarean section is not fully protective against PFD and incontinence.
Pregnancy hormones and the growing weight of the fetus and uterus influence structural changes that occur in early pregnancy.
Structural Changes Include:
- Levator hiatal dimensions increase
- Contractility and distensibility of pelvic floor muscles increases
- Bladder neck position changes, hypermobile
- Functional urethral length increases
Prognostic Factors
Significant Prenatal Risk Factors Include:
Incontinence symptoms before or during pregnancy
A history of general or acute pelvic pain
Low back pain
Obesity
Early menarche (the age that menstruation starts)
Depression
Emotional distress during pregnancy (such as intimate partner violence, housing and financial instability)
Smoking and/or a chronic cough
Recurrent urinary tract infections
Low education
Pain with sex
Vigorous exercise (such as horseback riding, yoga, or dancing)
Being a person of color *Learn more about why race is a risk factor
Evidence of Success
Researchers have successfully predicted SUI with 87% sensitivity (true positive rate of SUI) and 77% specificity (true negative rate of SUI) using these prognostic factors.
The literature illustrates a strong connection to pelvic floor dysfunction and the physical history, social, and emotional condition of the pregnant person. This means that providers and clients can both anticipate the development of SUI and start taking measures to prevent this type of pelvic floor dysfunction.