title: Association of postpartum depressive symptoms and urinary incontinence. A cohort study.
abstract: OBJECTIVE
  Our objective was to clarify whether de novo urinary incontinence (UI) in the postpartum period is associated with depressive symptoms or antidepressant drug consumption.
  
  
  METHODS
  2002 pregnant women were recruited between 2003 and 2006 for the EDEN mother-child cohort. This analysis included 1413 women who reported no UI before pregnancy. Severity of UI was assessed by the Sandvik index. At 4 and 12 months postpartum, depressive symptoms were assessed by the Edinburgh Postpartum Depression Scale (EPDS≥10 defines depressive symptoms) and consumption of antidepressant drugs was reported.
  
  
  RESULTS
  At 4 months postpartum, 198 women (14%) reported de novo UI; 74% (n=146) reported mild UI, 26% (n=52) moderate, and none severe; prevalence of depressive symptoms was higher in women with than without UI (22.1% vs. 15.9%, p=0.045), and consumption of antidepressant drugs was more frequent (4.7% vs. 1.4%, p=0.005). At 12 months postpartum, the mean (±SD) EPDS score differed between women with than without UI (7.30±3.46 vs. 6.57±3.72, p=0.016) but was half that at 4 months postpartum. The incidence of new cases of depressive symptoms or antidepressant consumption at 12 months was greater with than without UI (23.8% vs. 15.3%, p=0.012).
  
  
  CONCLUSIONS
  Although UI is mild in most cases at 4 months postpartum, it is followed by more new cases of depressive symptoms or antidepressant consumption at 12 months.
authors.affiliation: Université de Poitiers, Faculté de Médecine et Pharmacie, INSERM CIC1402, Poitiers, France; CHU de Poitiers, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Poitiers, France; INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, Univ Paris-Sud, UMRS 1018, Kremlin-Bicêtre, France; Institut National des Etudes Démographiques, Paris, France. Electronic address: xavier.fritel@univ-poitiers.fr.
authors.forename: Xavier
authors.initials: X
authors.lastname: Fritel
authors.affiliation: INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne-Paris-Cité, DHU Risks in Pregnancy, Paris Descartes University, France.
authors.forename: Yawo Edem
authors.initials: YE
authors.lastname: Tsegan
authors.affiliation: CHU de Poitiers, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Poitiers, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Pierre
authors.affiliation: INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne-Paris-Cité, DHU Risks in Pregnancy, Paris Descartes University, France.
authors.forename: Marie-Josèphe
authors.initials: MJ
authors.lastname: Saurel-Cubizolles
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D015897:Comorbidity; D019052:Depression, Postpartum / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressant consumption; Cohort study; Postnatal depression; Postpartum care; Urinary incontinence