Abstract:

Postpartum urinary incontinence (PPUI), postpartum depression and anxiety are common comorbidities in women after delivery. They often coexist and exacerbate each other, gradually becoming a hotspot in clinical interdisciplinary research in recent years. Existing evidence indicates that PPUI can increase the risk of postpartum depression by approximately 45%, and the risk of anxiety in patients with severe PPUI can be up to 3.77 times that of those without urinary incontinence. Moreover, stress urinary incontinence and depression, as well as urgency urinary incontinence and anxiety, show specific associations, respectively. The comorbidity mechanisms encompass psychosocial pathways (shame, social avoidance, decreased social support) and neurobiological pathways (estrogen fluctuations leading to serotonin dysfunction, central sensitization, etc.). Notably, cultural and economic backgrounds may modulate their association, for instance, religious and cultural factors that can exacerbate the psychological burden associated with urinary incontinence. Current research is predominantly based on cross-sectional designs, leaving the causal temporal sequence and dynamic evolution patterns unclear. Additionally, there is a lack of large-sample longitudinal evidence from large domestic studies. Future efforts should focus on conducting long-term cohort studies to clarify the causal relationship and establishing an interdisciplinary integrated intervention model combing pelvic floor rehabilitation with mental health support, aiming to provide more comprehensive health management strategies for postpartum women.

Key words: Postpartum period, Urinary incontinence, Depression, postpartum, Anxiety, Puerperal disorders