Risk factors for postpartum urinary retention: A systematic review and meta-analysis

F. E M Mulder, M. A. Schoffelmeer, R. A. Hakvoort, J. Limpens, B. W J Mol, J. A M Van Der Post, J. P W R Roovers

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background Postpartum urinary retention (PUR) is a common condition with varying prevalence. Measurement of the post-void residual volume (PVRV) is not regularly performed. Various studies have been published on overt (the inability to void after giving birth, requiring catheterisation) and covert (an increased PVRV after spontaneous micturition) PUR. To evaluate which clinical prognostic factors are related to PUR, the identification of independent risk factors for covert and overt PUR is needed. Objectives We performed a systematic review and meta-analysis of observational studies reporting on risk factors for PUR. Search strategy Systematic search of MEDLINE and EMBASE to September 2011. Selection criteria Articles that reported on women diagnosed with PUR or with an abnormal PVRV. Data collection and analysis The included articles were selected by two authors. We constructed two-by-two tables for potential risk factors of overt and covert PUR and calculated pooled odds ratios (ORs) with 95% confidence intervals. Main results Twenty-three observational studies with original data were eligible for data extraction, of which 13 could be used for meta-analysis. Statistically significant risk factors for overt PUR were epidural analgesia (OR 7.7), instrumental delivery (OR 4.5), episiotomy (OR 4.8) and primiparity (OR 2.4). For covert PUR, variety in the definitions used resulted in heterogeneity; no significant prognostic factors were found. Conclusions Instrumental delivery, epidural analgesia, episiotomy and nulliparity are statistically significantly associated with a higher incidence of overt PUR. The same factors were identified for covert PUR, but without statistical significance. Uniformity in definitions in future research is essential to create a prognostic model.

LanguageEnglish
Pages1440-1446
Number of pages7
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume119
Issue number12
DOIs
Publication statusPublished - 1 Nov 2012

Keywords

  • Meta-analysis
  • postpartum period
  • risk factors
  • systematic review
  • urinary retention
  • voiding dysfunction

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Mulder, F. E. M., Schoffelmeer, M. A., Hakvoort, R. A., Limpens, J., Mol, B. W. J., Van Der Post, J. A. M., & Roovers, J. P. W. R. (2012). Risk factors for postpartum urinary retention: A systematic review and meta-analysis. BJOG: An International Journal of Obstetrics and Gynaecology, 119(12), 1440-1446. https://doi.org/10.1111/j.1471-0528.2012.03459.x
Mulder, F. E M ; Schoffelmeer, M. A. ; Hakvoort, R. A. ; Limpens, J. ; Mol, B. W J ; Van Der Post, J. A M ; Roovers, J. P W R. / Risk factors for postpartum urinary retention : A systematic review and meta-analysis. In: BJOG: An International Journal of Obstetrics and Gynaecology. 2012 ; Vol. 119, No. 12. pp. 1440-1446.
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abstract = "Background Postpartum urinary retention (PUR) is a common condition with varying prevalence. Measurement of the post-void residual volume (PVRV) is not regularly performed. Various studies have been published on overt (the inability to void after giving birth, requiring catheterisation) and covert (an increased PVRV after spontaneous micturition) PUR. To evaluate which clinical prognostic factors are related to PUR, the identification of independent risk factors for covert and overt PUR is needed. Objectives We performed a systematic review and meta-analysis of observational studies reporting on risk factors for PUR. Search strategy Systematic search of MEDLINE and EMBASE to September 2011. Selection criteria Articles that reported on women diagnosed with PUR or with an abnormal PVRV. Data collection and analysis The included articles were selected by two authors. We constructed two-by-two tables for potential risk factors of overt and covert PUR and calculated pooled odds ratios (ORs) with 95{\%} confidence intervals. Main results Twenty-three observational studies with original data were eligible for data extraction, of which 13 could be used for meta-analysis. Statistically significant risk factors for overt PUR were epidural analgesia (OR 7.7), instrumental delivery (OR 4.5), episiotomy (OR 4.8) and primiparity (OR 2.4). For covert PUR, variety in the definitions used resulted in heterogeneity; no significant prognostic factors were found. Conclusions Instrumental delivery, epidural analgesia, episiotomy and nulliparity are statistically significantly associated with a higher incidence of overt PUR. The same factors were identified for covert PUR, but without statistical significance. Uniformity in definitions in future research is essential to create a prognostic model.",
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Mulder, FEM, Schoffelmeer, MA, Hakvoort, RA, Limpens, J, Mol, BWJ, Van Der Post, JAM & Roovers, JPWR 2012, 'Risk factors for postpartum urinary retention: A systematic review and meta-analysis', BJOG: An International Journal of Obstetrics and Gynaecology, vol. 119, no. 12, pp. 1440-1446. https://doi.org/10.1111/j.1471-0528.2012.03459.x

Risk factors for postpartum urinary retention : A systematic review and meta-analysis. / Mulder, F. E M; Schoffelmeer, M. A.; Hakvoort, R. A.; Limpens, J.; Mol, B. W J; Van Der Post, J. A M; Roovers, J. P W R.

In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 119, No. 12, 01.11.2012, p. 1440-1446.

Research output: Contribution to journalArticle

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T2 - BJOG: An International Journal of Obstetrics and Gynaecology

AU - Mulder, F. E M

AU - Schoffelmeer, M. A.

AU - Hakvoort, R. A.

AU - Limpens, J.

AU - Mol, B. W J

AU - Van Der Post, J. A M

AU - Roovers, J. P W R

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N2 - Background Postpartum urinary retention (PUR) is a common condition with varying prevalence. Measurement of the post-void residual volume (PVRV) is not regularly performed. Various studies have been published on overt (the inability to void after giving birth, requiring catheterisation) and covert (an increased PVRV after spontaneous micturition) PUR. To evaluate which clinical prognostic factors are related to PUR, the identification of independent risk factors for covert and overt PUR is needed. Objectives We performed a systematic review and meta-analysis of observational studies reporting on risk factors for PUR. Search strategy Systematic search of MEDLINE and EMBASE to September 2011. Selection criteria Articles that reported on women diagnosed with PUR or with an abnormal PVRV. Data collection and analysis The included articles were selected by two authors. We constructed two-by-two tables for potential risk factors of overt and covert PUR and calculated pooled odds ratios (ORs) with 95% confidence intervals. Main results Twenty-three observational studies with original data were eligible for data extraction, of which 13 could be used for meta-analysis. Statistically significant risk factors for overt PUR were epidural analgesia (OR 7.7), instrumental delivery (OR 4.5), episiotomy (OR 4.8) and primiparity (OR 2.4). For covert PUR, variety in the definitions used resulted in heterogeneity; no significant prognostic factors were found. Conclusions Instrumental delivery, epidural analgesia, episiotomy and nulliparity are statistically significantly associated with a higher incidence of overt PUR. The same factors were identified for covert PUR, but without statistical significance. Uniformity in definitions in future research is essential to create a prognostic model.

AB - Background Postpartum urinary retention (PUR) is a common condition with varying prevalence. Measurement of the post-void residual volume (PVRV) is not regularly performed. Various studies have been published on overt (the inability to void after giving birth, requiring catheterisation) and covert (an increased PVRV after spontaneous micturition) PUR. To evaluate which clinical prognostic factors are related to PUR, the identification of independent risk factors for covert and overt PUR is needed. Objectives We performed a systematic review and meta-analysis of observational studies reporting on risk factors for PUR. Search strategy Systematic search of MEDLINE and EMBASE to September 2011. Selection criteria Articles that reported on women diagnosed with PUR or with an abnormal PVRV. Data collection and analysis The included articles were selected by two authors. We constructed two-by-two tables for potential risk factors of overt and covert PUR and calculated pooled odds ratios (ORs) with 95% confidence intervals. Main results Twenty-three observational studies with original data were eligible for data extraction, of which 13 could be used for meta-analysis. Statistically significant risk factors for overt PUR were epidural analgesia (OR 7.7), instrumental delivery (OR 4.5), episiotomy (OR 4.8) and primiparity (OR 2.4). For covert PUR, variety in the definitions used resulted in heterogeneity; no significant prognostic factors were found. Conclusions Instrumental delivery, epidural analgesia, episiotomy and nulliparity are statistically significantly associated with a higher incidence of overt PUR. The same factors were identified for covert PUR, but without statistical significance. Uniformity in definitions in future research is essential to create a prognostic model.

KW - Meta-analysis

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