Intrapartum risk factors for postpartum urinary retention: a case-control study

Introduction Urinary voiding dysfunction is a common postpartum condition. Increased knowledge of risk factors for postpartum urinary retention could improve early identification of women at risk and lead to enhanced postpartum surveillance. We sought to identify intrapartum factors that contribute to postpartum urinary retention. Methods This retrospective case-control study compared subjects who developed postpartum urinary retention requiring indwelling catheterization after vaginal delivery to a control group who did not require catheterization. The control group was randomly selected in a 1:4 ratio. Continuous data were analyzed using a two-sample t-test and Mann-Whitney U test. Categorical data were analyzed using Fisher's exact test and two proportions test. Logistic regression was performed to identify variables independently associated with increased risk for development of postpartum urinary retention. Results A total of 5802 women who delivered vaginally met eligibility criteria with 38 women (0.65%) experiencing postpartum urinary retention. Logistic regression revealed that nulliparity, >= 2nd-degree obstetrical laceration, and intermittent catheterization during labor were independently associated with increased risk for postpartum urinary retention. Conclusion No single factor predicted development of postpartum urinary retention; however, a higher index of suspicion after vaginal delivery is warranted for nulliparous women, >= 2nd-degree obstetrical laceration, and if intermittent catheterization during labor was required.