The impact of lower urinary tract symptoms on the quality of life during pregnancy: a cross-sectional study from Palestine

(2020) 20:191 Ahmad et al. BMC Urol https://doi.org/10.1186/s12894-020-00761-9 RESEARCH ARTICLE Open Access The impact of lower urinary tract symptoms on the quality of life during pregnancy: a crosssectional study from Palestine Qais T. Ahmad1, Jaffar H. Saffarini1, Ahmad M. Samara1, Dima S. Jabri1, Zaina H. Safarini1, Yousra M. Banijaber1, Ahmad Jaradat1,2, Faris Abushamma1,2 and Sa’ed H. Zyoud3,4,5* Abstract Background: Lower urinary tract symptoms (LUTS) are prevalent among pregnant women. Several articles show the impact of LUTS on pregnant women’s quality of life (QoL). This study was designed to examine the impact of nonpathological LUTS on QoL among pregnant Palestinian women. Methods: A cross-sectional, hospital-based study was conducted on women who were pregnant and receiving regular antenatal care at the obstetrics and gynecology clinic in Rafidia Hospital, Palestine. This self-administered questionnaire included the Urinary Distress Inventory – short-form (UDI-6), the Incontinence Impact Questionnaire – short-form (IIQ-7), the European Quality of Life scale – 5 dimensions (EQ-5D), and the European Quality of Life – visual analogue scale (EQ-VAS). A convenience sampling method was used. In addition to this, multiple linear regression analyses were performed aiming to identify variables that have a significant relationship with QoL (i.e. socio-demographic variables, UDI-6 score, and IIQ-7 score). Results: This study included a total of 306 pregnant women. Participants had a mean age of 26.9 years (SD, 3.6). The subjects scored an average of 31.2 ± 19.2 out of 100 points for the UDI-6 scale and an average of 31.9 ± 24.9 out of 100 points for the IIQ-7 scale. On the other hand, the subjects’ average EQ-5D and EQ-VAS scores were 0.76 ± 0.17 and 67.96 ± 19.28 respectively. The subjects’ responses on UDI-6 significantly correlated with their responses on both the EQ-5D and EQ-VAS scales (r = − 0.338, p < 0.001 and r = − 0.206, p < 0.001, respectively). Likewise, their responses on IIQ-7 also significantly correlated with their responses on both the EQ-5D and EQ-VAS scales (r = − 0.389, p < 0.001 and r = − 0.329, p < 0.001, respectively). Regression analysis found that the UDI-6 score (p = 0.001) and IIQ-7 score (p < 0.001), were significantly and negatively associated with EQ-5D index scores. Conclusions: Our study shows a remarkable correlation between LUTS and QoL among pregnant women. Further longitudinal studies are required to assess the status of LUTS in the pre-pregnancy stage to ascertain a more accurate assessment of LUTS or LUTS related intervention and its impact on QoL during pregnancy. Keywords: Lower urinary tract symptoms, Quality of life, Pregnancy, Palestine *Correspondence: ; 3 Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus 44839, Palestine Full list of author information is available at the end of the article Background Pregnancy is a physiological process that entails several multisystem changes [1]. Pathological conditions may appear during pregnancy such as Urinary tract infections (UTIs), pre-eclampsia, and gestational diabetes [2]. Few reports have been conducted to date to assess the © The Author(s) 2020. 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The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Ahmad et al. BMC Urol (2020) 20:191 impact of lower urinary tract symptoms (LUTS) during pregnancy [3–5]. LUTS can have negative effects on the social, physical, and emotional well-being of pregnant women [6]. Pregnancy-related LUTS, despite not being a pathological condition by definition, account for a significant amount of urinary distress and can affect quality of life (QoL) during pregnancy [7]. Moreover, the prevalence of urinary symptoms and distress during pregnancy could be under-reported due to the intimate nature of these symptoms [8]. QoL during pregnancy, with its effect on women’s physical and mental health, is an important topic that can be directly affected by the presence of LUTS [9–11]. Several reports have been published in order to identify and manage these symptoms early in pregnancy, such as antenatal urinary incontinence screening, health education regarding risk factors for urinary incontinence, and highlighting the importance of early recognition and management [7]. In Palestine, there has been a growing interest in studying QoL indices in different populations and how this may be impacted by different variables and factors [12– 19]. However, the impact of LUTS on the QoL among pregnant women has not been examined before. Therefore, this study aimed to examine the impact of nonpathological LUTS on the overall QoL during pregnancy, and to identify factors that might directly affect the QoL. The merit of this study shadows the growing trend to integrate LUTS management into routine pregnancycare, and planning personalised care for pregnant women in relation to these symptoms based on their unique risks and needs. Our results provide key data from the clinical setting demonstrating the extent to which LUTS affects pregnant women’s physical and psychological well-being. This in turn allows for better planning and establishment of management protocols for the problem in order to improve pregnancy and health outcomes in general. Finally, the current study will provide a reference point for health officials in order to assess the efficiency of any future interventions to address this problem. Methods Study design This was a cross-sectional study that assessed the impact of LUTS on QoL during pregnancy. It used questionnaire-based interviews to collect data from the study subjects. Study setting and study population The survey took place at the obstetrics and gynecology clinic in Rafidia Hospital. The target population was pregnant women aged between 18 and 40 years. Data was collected between September 2019 and February 2020. Page 2 of 10 The appointments were (...truncated)