THE MAMMI STUDY FINDINGS TO DATE (up to end of … Incontinence in Primiparous Women...maternal...
1
THE MAMMI STUDY (M aternal health A nd M aternal M orbidity in I reland) INTRODUCTION The MAMMI Study is a mixed method study exploring the health of and morbidities experienced by 1600 first-time mothers in Ireland. AIM The aim of the MAMMI Study (urinary incontinence (UI) strand) is to identify the existence, extent, prevalence and associated risk factors for urinary incontinence (UI), one marker of maternal morbidity, in 1600 primiparous women antenatally and at 3 and 6 months postpartum. FINDINGS TO DATE (up to end of April 2013) FINDINGS FROM SUB GROUPS SUI and BMI category Déirdre Daly 1 , Professor Cecily Begley 1 and Professor Mike Clarke 2 Contact Deirdre Daly Lecturer in Midwifery/HRB Research Fellow School of Nursing and Midwifery 24 D’Olier Street Trinity College Dublin Dublin 2. Email: [email protected] + 353 1 8962604 Funders The MAMMI study (UI) strand is funded by the HRB HRB Grant HPF 2011/18 Trinity College Dublin CONTEXT There are no publically available data on maternal health and health problems following discharge from the maternity hospitals in Ireland Women’s attendances at health services or readmissions to hospitals are not linked to their maternity records (i.e. there is no connectivity between their records) METHODS The MAMMI Study (M aternal health A nd M aternal M orbidity in I reland) study - Urinary Incontinence (UI) strand is a mixed methods study comprising (i) Self-completion questionnaires administered at 5 time points: antenatally and at 3, 6, 9 and 12 months postpartum (ii) Data collection from women’s records 1600 primiparous women (A/N, 3, 6, 9 and 12 months postpartum) Data collection from women’s records General health Mental health Pain Urinary incontinence (UI) Faecal incontinence Sexual health Intimate partner violence OBJECTIVES (i) to identify the existence, extent and prevalence of UI up to 6 months postpartum for women having their first baby (ii) to identify associated factors for UI including but not limited to: age; Body Mass Index (BMI); infant birth weight and perineal trauma The MAMMI STUDY STRANDS Population profile Age Group The MAMMI Study (n= 817) % Site hospital 2011 (n= 4151) % Up to 24 77 9.4 976 23.5 25 to 29 195 23.9 1137 27.4 30 to 34 341 41.7 1314 31.7 35 to 39 176 21.5 581 14.0 40 and over 28 3.4 143 3.4 Total 817 100 4151 100 Age group Status The MAMMI Study (n =815) % ESRI 2011 (n = 74,377) % Married 502 61.4 48,492 65.2 Divorced/ separated 2 0.2 1,063 1.4 Single/living with partner/in a relationship, not living together 36 4.4 24,667 33.2 Other 7 0.9 64 0.1 Relationship status DEFINITIONS OF URINARY INCONTINENCE Abrams et al (2002) International Consultation on Incontinence 2 nd edition. Available at: http://www.ics.org/Publications/ICI_4/book.pdf Frequency Occasionally One or several times a month One or several times a week Every day URINARY INCONTINENCE BEFORE AND DURING PREGNANCY Acknowledgements Sincerest thanks to the women who are participating in the study The Midwives and midwifery students who are giving the women the information The MAMMI Study team members Margaret Carroll, Senior Lecturer in Midwifery Deirdre O Malley, Clinical Tutor in Midwifery Francesca Wuytack, PhD student Professor Stephanie Brown, MCRI, Melbourne, Victoria, Australia for granting permission to use and modify the surveys in an Irish setting RELEVANCE Did women talk to a healthcare professional ? Talked to a healthcare professional about leaking urine - women with SUI only (n = 178) 12 months before pregnancy In early pregnancy Yes 13 7.3 17 9.6 No 161 90.4 161 90.4 Total 174 97.8 178 100.0 SUMMARY Analysis of data from these 817 women show that More than 1 in 3 participants experienced some degree of urinary incontinence at the start of pregnancy and most did not talk to a healthcare professional Women reporting occasional UI before pregnancy have raised odds of developing UI during pregnancy Brown et al 2010 Women who develop UI during the first pregnancy or puerperium have a significantly higher risk of UI 5 years later than women without UI symptoms Viktrup & Lose 2000 DOES THIS MATTER? THE CONCLUDING MESSAGE Preliminary data (n = 817) ~40% of primiparous women are being offered information on the MAMMI study Of those given the information, about two in five complete the survey Response rate (~40%) Author information: 1 Trinity College Dublin. 2 Queen’s University Belfast KEY POINTS 178 women (21.8%) had some degree of SUI before pregnancy 263 women (32.2%) had some degree of SUI during early pregnancy KEY POINTS 132 women (21%) experienced SUI in early pregnancy KEY POINTS SUI persisted in 121 (73.6%) participants BMI category The MAMMI Study (n= 666) % Underweight <15.49 50 6.1 Ideal (15.5-24.99) 438 53.6 Overweight (25-29.99) 113 13.8 Obese (30-34.99) 53 6.5 Very obese (35+) 12 1.5 Missing 151 18.5 Total 666 81.5 KEY POINTS 141 women (28.9%) with BMI < 25 had SUI in early pregnancy 80 women (45%) with BMI > 25 had SUI in early pregnancy Whilst UI remain undisclosed and not discussed, women who could become continent will continue to be incontinent Urinary incontinence is common but it is not normal and can be treated Women do not talk to healthcare professionals about UI, therefore we need to ask women.
Transcript of THE MAMMI STUDY FINDINGS TO DATE (up to end of … Incontinence in Primiparous Women...maternal...
THE MAMMI STUDY (Maternal health And Maternal Morbidity in Ireland)
INTRODUCTION
The MAMMI Study is a mixed method study exploring the health of and morbidities experienced by 1600 first-time mothers in Ireland.
AIM
The aim of the MAMMI Study (urinary incontinence (UI) strand) is to identify the existence, extent, prevalence and associated risk factors for urinary incontinence (UI), one marker of maternal morbidity, in 1600 primiparous women antenatally and at 3 and 6 months postpartum.
FINDINGS TO DATE (up to end of April 2013)
FINDINGS FROM SUB GROUPS SUI and BMI category
Déirdre Daly1, Professor Cecily Begley1 and Professor Mike Clarke2
Contact Deirdre Daly Lecturer in Midwifery/HRB Research Fellow School of Nursing and Midwifery 24 D’Olier Street Trinity College Dublin Dublin 2. Email: [email protected] + 353 1 8962604
Funders The MAMMI study (UI) strand is funded by the HRB HRB Grant HPF 2011/18
Trinity College Dublin
CONTEXT
There are no publically available data on maternal health and health problems following discharge from the maternity hospitals in Ireland
Women’s attendances at health services or readmissions to hospitals are not linked to their maternity records (i.e. there is no connectivity between their records)
METHODS The MAMMI Study (Maternal health And Maternal Morbidity in Ireland) study - Urinary Incontinence (UI) strand is a mixed methods study comprising
(i) Self-completion questionnaires administered at 5 time points: antenatally and at 3, 6, 9 and 12 months postpartum
(ii) Data collection from women’s records
1600 primiparous women
(A/N, 3, 6, 9 and 12 months postpartum)
Data collection from women’s records
General health
Mental health
Pain
Urinary incontinence
(UI)
Faecal incontinence
Sexual health
Intimate partner violence
OBJECTIVES
(i) to identify the existence, extent and prevalence of UI up to 6 months postpartum for women having their first baby
(ii) to identify associated factors for UI including but not limited to: age; Body Mass Index (BMI); infant birth weight and perineal trauma
The MAMMI STUDY STRANDS
Population profile
Age Group The MAMMI Study
(n= 817)
% Site hospital 2011
(n= 4151) %
Up to 24 77 9.4 976 23.5
25 to 29 195 23.9 1137 27.4
30 to 34 341 41.7 1314 31.7
35 to 39 176 21.5 581 14.0
40 and over 28 3.4 143 3.4
Total 817 100 4151 100
Age group
Status The MAMMI Study
(n =815)
% ESRI 2011 (n = 74,377)
%
Married 502 61.4 48,492 65.2 Divorced/ separated
2 0.2 1,063 1.4
Single/living with partner/in a relationship, not living
together
36 4.4 24,667 33.2
Other 7
0.9 64 0.1
Relationship status
DEFINITIONS OF URINARY INCONTINENCE
Abrams et al (2002) International Consultation on Incontinence 2nd edition. Available at: http://www.ics.org/Publications/ICI_4/book.pdf Frequency Occasionally One or several times a month One or several times a week Every day
URINARY INCONTINENCE BEFORE AND DURING PREGNANCY
Acknowledgements Sincerest thanks to the women who are participating in the study The Midwives and midwifery students who are giving the women the information
The MAMMI Study team members Margaret Carroll, Senior Lecturer in Midwifery Deirdre O Malley, Clinical Tutor in Midwifery Francesca Wuytack, PhD student
Professor Stephanie Brown, MCRI, Melbourne, Victoria, Australia for granting permission to use and modify the surveys in an Irish setting
RELEVANCE
Did women talk to a healthcare professional ?
Talked to a healthcare professional about leaking urine - women
with SUI only (n = 178)
12 months before pregnancy In early pregnancy
Yes 13 7.3 17 9.6
No 161 90.4 161 90.4
Total 174 97.8 178 100.0
SUMMARY Analysis of data from these 817 women show that More than 1 in 3 participants experienced some degree of urinary incontinence at the start of pregnancy and most did not talk to a healthcare professional
Women reporting occasional UI before pregnancy have raised odds of developing UI during pregnancy Brown et al 2010
Women who develop UI during the first pregnancy or puerperium have a significantly higher risk of UI 5 years later than women without UI symptoms Viktrup & Lose 2000
DOES THIS MATTER?
THE CONCLUDING MESSAGE
Preliminary data (n = 817)
~40% of primiparous women are being offered information on the MAMMI study
Of those given the information, about two in five complete the survey
Response rate (~40%)
Author information: 1 Trinity College Dublin. 2 Queen’s University Belfast
KEY POINTS
178 women (21.8%) had some degree of SUI before pregnancy
263 women (32.2%) had some degree of SUI during early pregnancy
KEY POINTS
132 women (21%) experienced SUI in early pregnancy
KEY POINTS
SUI persisted in 121 (73.6%) participants
BMI category The MAMMI Study (n= 666)
%
Underweight <15.49 50 6.1
Ideal (15.5-24.99) 438 53.6
Overweight (25-29.99) 113 13.8
Obese (30-34.99) 53 6.5
Very obese (35+) 12 1.5
Missing 151 18.5
Total 666 81.5
KEY POINTS
141 women (28.9%) with BMI < 25 had SUI in early pregnancy
80 women (45%) with BMI > 25 had SUI in early pregnancy
Whilst UI remain undisclosed and not discussed, women who could become continent will continue to be incontinent
Urinary incontinence is common but it is not normal and can be treated
Women do not talk to healthcare professionals about UI, therefore we need to ask women.
