The prevalence and the knowledge level of urinary incontinence among women with history of at least one childbirth living in Yerevan, Armenia

Abstract

Background: Unintentional urination or urinary incontinence (UI) is considered a neglected public health problem. In women, pregnancy and childbirth are considered leading factors associated with the development of UI. Most studies have reported a UI prevalence rate ranging between 25% and 45.0%. However, women often fail to report their symptoms because of the perception of normality of problem, fear of surgical treatment, and embarrassment. UI knowledge proficiency is one of the critical determinants influencing the recognition and treatment of UI when it is in its early stages to prevent it from worsening. Given insufficient UI-related data in Armenia, this study aimed to estimate the prevalence of UI, knowledge proficiency of and help-seeking behavior for UI among women residing in Yerevan and with history of at least one childbirth. Methods: The cross-sectional online survey was conducted among mothers of children enrolled in American University of Armenia experimental English classes (EEC) afterschool English program during April 2020. The instrument was based on the UI domain of prolapse and incontinence knowledge quiz (PIKQ), the urinary distress inventory, short-form (UDI-6). The survey also included sections on mothers’ demographic characteristics, health conditions, pregnancy and childbirth, and on mothers’ UI related help-seeking behavior. Descriptive, univariate and multivariable logistic regression analyses were conducted using Stata 13.0. Results: A total of 166 participants completed surveys. The mean age of study participants was 39.0 years (SD = 4.6). The prevalence of UI was 48.5% and “high” UI knowledge proficiency was 20.0% among mothers of children enrolled in the AUA EEC afterschool English program. Findings from the univariate analysis revealed that work in a medical field, age of the mother at first childbirth, and the occurrence of urgency urinary incontinence (UUI) were significantly associated with the “high” UI knowledge proficiency. In the multivariable analysis, the odds of the “high” UI knowledge proficiency among mothers who ever worked in a medical field was 6.3 times the odds of the “high” UI knowledge proficiency among mothers who had never worked in a medical field after adjusting the occurrence of UUI (p < 0.001). The odds of the “high” UI knowledge proficiency among mothers who did not report UUI was 65% lower than those of mothers who reported UUI, when work in a medical field was present in the model (OR: 0.35; p = 0.037). About 59.6% of mothers did not seek help for any of urinary distress symptoms after last childbirth and 64.3% of them indicated that they did not approach physicians as “symptoms were not bothering them too much”. Conclusion: The study underlines that women with history of at least one childbirth have low knowledge proficiency in UI. Despite the fact that UI was a prevalent condition among study participants, women were unaware that childbirth was a known risk factor for UI. The findings underline the need for education on UI among women of childbearing age.