{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:38:27Z","timestamp":1790188707829,"version":"4.1.0"},"reference-count":33,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T00:00:00Z","timestamp":1758412800000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,14]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore how urinary (UI) and anal incontinence (AI) affect various aspects of quality of life (QoL) and the risk of depression 6\u2009months postpartum, using patient-reported outcome measures (PROMs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and setting<\/jats:title>\n                    <jats:p>Women who gave birth between 2020 and 2022 within a local obstetric collaborative network in the Netherlands, including 13 midwifery practices, 5 maternity care organisations at the primary care level, and 1 secondary teaching hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Prospectively collecting data by using the questionnaires of the International Consortium for Health Outcome Measures Pregnancy and Childbirth set at five moments during pregnancy and postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Associations between UI, AI, QoL and likelihood of depression based on PROMs collected from questionnaire 6\u2009months postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 663\u2009women who completed the 6-month postpartum questionnaire, 79\u2009women had severe UI, 71 had severe AI and 45 experienced both. These women reported significantly lower QoL as measured by PROMIS-10: 34 (IQR 30.5\u201338.5), 34 (IQR 30\u201339.5), and 32 (IQR 27\u201335), respectively, compared with a score of 37 (IQR 33\u201342) for the total population. Additionally, the positive rate for depression screening was notably higher among these groups, with rates of 6%, 10% and 18%, respectively, compared with 3% for the overall group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this observational cohort study, we found that severe UI and\/or AI 6\u2009months postpartum significantly impact QoL and increase the likelihood of depression, as indicated by PROMs. Our findings emphasise the importance of screening, evaluation and treatment of UI and\/or AI to improve the QoL and reduce the risk of depressive disorders for postpartum women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-101517","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T02:31:15Z","timestamp":1758508275000},"page":"e101517","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Impact of postpartum urinary and anal incontinence on patient-reported quality of life and risk of depressive disorder in women receiving primary and secondary care in the Netherlands: a prospective cohort study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3127-0981","authenticated-orcid":false,"given":"Ellen","family":"Mooren","sequence":"first","affiliation":[{"name":"Department of Gynaecology, Ziekenhuis Rivierenland, Tiel, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke G","family":"Posthumus","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneke","family":"Steensma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacoba","family":"van der Kooy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie","family":"Speksnijder","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Amphia Hospital, Breda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,9,21]]},"reference":[{"key":"2025120806351514000_15.9.e101517.1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s41687-018-0061-6","article-title":"How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? 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