Postpartum Depression Tied To Incontinence


ATLANTA — Women with postpartum depression are more likely than are nondepressed women to have urge urinary incontinence, according to findings presented in a poster at the annual meeting of the American Urogynecologic Society.

Of 146 women in the cross-sectional study, 12% had postpartum depression at the 6-week visit as measured by the Edinburgh Postnatal Depression Scale. At that time, those with depression had a fourfold increase in overall and subscale scores on the Urge-Incontinence Impact Questionnaire (UIIQ), compared with nondepressed women.

This finding suggests depressed patients have more symptoms and a greater impact on their lives from urge urinary incontinence, Dee Fenner, M.D., said.

Depressed and nondepressed patients were similar in age, race, parity, and body mass index. On multivariate analysis, depression scores were shown to be affected by UIIQ score, smoking, and infant feeding mode (bottle vs. breast). But urge incontinence symptoms had the greatest effect on depression scores.

In addition, depressed patients were more than twice as likely to have had a cesarean delivery, Dr. Fenner said.

That finding amplifies the association between urinary incontinence and postpartum depression because studies have shown women who have a C-section are less likely to develop urge urinary incontinence than are those who deliver vaginally, Dr. Fenner noted.

“We hope this will serve for future studies as a model to predict the onset of depression and to actually work out whether or not this is the depression causing the incontinence or the incontinence causing the depression,” she said.

The model could also aid in assessing the role of various markers, such as cortisol levels, hormone fluctuations, and neurotransmitters in depression and incontinence.

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