The risk factors of postpartum urinary retention after vaginal delivery: A systematic review.

Objectives: This review aimed to explore the independent risk factors of postpartum urinary retention (PUR) after a vaginal delivery.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed and relevant studies were retrieved from eleven databases. The quality of the included articles was assessed using Critical Appraisal Skills Programme tools or the Appraisal tool for Cross-Sectional Studies. The data analysis was performed using Review Manager version 5.3.

Results: A total of nine articles were included and five risk factors were identified, namely, episiotomy ( OR  = 2.99, 95%CI = 1.31-6.79, P  = 0.009), epidural analgesia ( OR  = 2.48, 95%CI = 1.09-5.68, P  = 0.03), primiparity ( OR  = 2.17, 95%CI = 1.06-4.46, P  = 0.03), instrumental delivery ( OR  = 4.01, 95%CI = 1.97-8.18, P  < 0.001), and the duration of the second stage of labor ( MD  = 15.24, 95%CI = 11.20-19.28, P  < 0.001). However, fetal birth weights of more than 3800 g were not identified as an independent risk factor ( MD  = 64.41, 95%CI = -12.59 to 141.41, P  = 0.10).

Conclusion: This systematic review indicated that the independent risk factors for PUR were found to include episiotomy, epidural analgesia, instrumental delivery, primiparity, and a longer second stage of labor. In clinical practice, healthcare providers could pay more attention to women with these factors and prevent postpartum urinary retention.