Risk factors for postpartum urinary retention after vaginal delivery among primiparous women: a retrospective case-control study

Abstract

Background: Postpartum urinary retention (PUR) usually occurs in the immediate postpartum period among the women after vaginal delivery. The recognition of risk factors may enable early and prompt diagnosis. Methods: We conducted a retrospective matched case-control study to identify the risk factors for postpartum urinary retention in primiparous women after vaginal delivery between July 2016 and January 2024. All data were collected through our hospital’s electronic health record system. Demographics, gestational and delivery characteristics were compared between groups by using univariate and multivariate analyses to identify the risk factors for postpartum urinary retention. Results: A total of 1275 primiparous women were included for analysis. In the multivariable logistic regression models, the risk factors were epidural analgesia (aOR 1.59, 95% CI 1.04 ~ 2.44, p = 0.032), duration of first stage (aOR 1, 95% CI 1 ~ 1, p < 0.001), duration of second stage (aOR 1.01, 95% CI 1.01 ~ 1.01, p < 0.001), episiotomy (aOR 2.23, 95% CI 1.68 ~ 2.95, p < 0.001), assisted delivery (aOR 2.15, 95% CI 1.34 ~ 3.45, p = 0.002) and postpartum haemorrhage (aOR 1.87, 95% CI 1.01 ~ 3.46, p = 0.047). Conclusion: Postpartum haemorrhage was also associated with PUR after vaginal delivery among primiparous women in addition to the frequently proposed risk factors such as epidural analgesia, labor duration, episiotomy and assisted delivery. Manual removal of placenta or placental membranes was associated with a lower rate of PUR.