Prognostic Potential of Clinical Factors, Serological Indicators, and Pelvic Floor Ultrasound Parameters in Women With Postpartum Stress Urinary Incontinence.

Abstract

Aims/Background Numerous studies have assessed factors influencing stress urinary incontinence (SUI); however, their findings are somewhat inconsistent. Therefore, this study aimed to explore the predictive potential of clinical characteristics and serological indicators combined with pelvic floor ultrasound parameters for postpartum SUI. Furthermore, the analysis was intended to determine the prevalence and factors affecting postpartum SUI among women in China. Methods This retrospective analysis included 511 parturient women who underwent prenatal examinations and gave birth at Yongkang Women and Children's Health Hospital between January 2023 and June 2024. Based on the occurrence of SUI within 6 months postpartum, the patients were divided into the SUI (204 cases) and the non-SUI (307 cases) groups. The baseline characteristics, serological indicators, and pelvic floor ultrasound parameters were comparatively analyzed between the two groups. Multivariable logistic regression analysis was applied to assess the factors affecting postpartum SUI. Furthermore, receiver operating characteristic (ROC) curves were drawn to determine the predictive efficacy of indicators that demonstrated statistically significant differences concerning postpartum SUI. Results The two study groups demonstrated statistically significant differences in mode of delivery and constipation during pregnancy (p < 0.05). The SUI group had significantly lower serum estradiol, progesterone, and 25-hydroxyvitamin [25(OH)D] than the non-SUI group (p < 0.05). Furthermore, the SUI group showed substantially higher bladder neck descent, urethral rotation angle, posterior urethrovesical angle, levator hiatus area, and urethral funnel formation than the non-SUI group (p < 0.05). The bladder neck descent, urethral rotation angle, posterior urethrovesical angle, levator hiatus area, and urethral funnel formation were identified as significant risk factors for postpartum SUI (p < 0.05). However, serum progesterone and 25(OH)D levels served as protective factors against SUI (p < 0.05). ROC analysis revealed that a combination of progesterone, 25(OH)D, bladder neck descent, urethral rotation angle, posterior urethrovesical angle, levator hiatus area, and urethral funnel formation significantly increased the area under the curve (AUC) to 0.975 (p < 0.001, 95% CI: 0.964-0.985), with a sensitivity of 0.946 and specificity of 0.860. Conclusion The study observed a relatively higher incidence of postpartum SUI among Chinese women, affected by various contributing factors. Combining serological indicators with pelvic floor ultrasound parameters indicated strong predictive efficacy for postpartum SUI.