Prediction of Risk Factors for Postpartum Urinary Retention in Primipara: A Case-Control Study.

Abstract

Background: Postpartum urinary retention (PUR) poses a risk of uterine contraction issues and postpartum vaginal bleeding. This research sought to examine the factors associated with PUR in primiparous women.

Methods: This study was case-control one involving all first-time mothers in our hospital between June 2022 and June 2024. The study cohort comprised 338 mothers with PUR, whereas the control cohort included 338 mothers without PUR. By conducting univariate analysis and logistic regression analyses, we identified the independent factors contributing to PUR in primiparous women. The discriminative ability of each risk factor, individually and in combination, in predicting the occurrence of PUR amongst first-time mothers was assessed through the receiver operating characteristic (ROC) curve and the area under the curve (AUC).

Results: Univariate analysis results displayed notable variances between the observation and control groups concerning the percentage of patients receiving labour analgesia, the duration of the second stage of labour, the incidence of episiotomy, the utilization of forceps delivery, the occurrence of manual rotation of the foetal head, average self-rating anxiety scale (SAS) score, and numeric rating scale (NRS) score (p < 0.05). Logistic regression analysis unveiled that labour analgesia (OR (95% confidence interval (CI)) = 1.528 (1.070-2.317)), prolonged second stage of labour (OR (95% CI) = 1.022 (1.009-1.034)), undergoing episiotomy (OR (95% CI) = 1.609 (1.313-1.803)), using forceps delivery (OR (95% CI) = 1.499 (1.182-2.718)), and higher NRS scores (OR (95% CI) = 1.387 (1.181-2.201)) all emerged as significant independent risk factors for PUR in primiparas. ROC analysis demonstrated that the AUC for the individual and combined predictive capacities of factors for predicting PUR in primiparas were 0.583, 0.607, 0.574, 0.558, 0.571, and 0.896. The combined prediction method had notably superior efficacy compared with the individual prediction using each factor.

Conclusions: The risk of PUR in primiparas is closely associated with the receipt of labour analgesia, a prolonged second stage of labour, episiotomy, the use of forceps delivery, and higher NRS scores. For primiparas with the above high-risk factors, early intervention during pregnancy and the perinatal period should be considered to reduce the incidence of PUR.