Analysis on influencing factors of postpartum urinary retention in vaginal delivery primiparas without labor analgesia

ZHANG E; ZHAO Yue; LAN Xueli; JU Rui

doi:10.3969/j.issn.1674-3806.2025.11.06

Abstract：Objective To explore influencing factors of postpartum urinary retention(PUR)in vaginal delivery primiparas without labor analgesia,and to provide evidence-based basis for the formulation of targeted preventive measures in clinical practice.Methods A total of 105 primiparas who were admitted to Beijing Obstetrics and Gynecology Hospital,Capital Medical University for vaginal delivery without labor analgesia from December 2021 to December 2024 were selected.According to whether the patients developed PUR,they were divided into non-PUR group(70 patients)and PUR group(35 patients).The general data and clinical indicators were compared between the two groups.Multivariate logistic regression was used to analyze the factors affecting the development of PUR and receiver operating characteristic(ROC)curve was used to analyze the efficacy of the research indicators in predicting PUR.Results There were statistically significant differences between the two groups in terms of postpartum hemorrhage volume,duration of the third stage of labor,classification of gestational weight gain,and midwifery method(P＜0.05).The results of multivariate logistic regression analysis indicated that excessive weight gain during pregnancy[OR(95％CI)=5.028(1.500-16.854),P=0.009],insufficient weight gain during pregnancy[OR(95％CI)=2.892(1.010-8.283),P=0.048]and large postpartum hemorrhage volume[OR(95％CI)=1.009(1.003-1.015),P=0.002]were independent risk factors for the development of PUR.The prediction model was constructed based on the above 3 risk factors.The results of ROC curve analysis indicated that the model could effectively predict the development of PUR[area under the curve(AUC)(95％CI)=0.762(0.663-0.861)],with a sensitivity of 65.7％,a specificity of 78.6％,and a Youden's index of 0.443.Conclusion The risk factors for the development of PUR after vaginal delivery in primiparas without labor analgesia are abnormal gestational weight gain(excessive weight gain or insufficient weight gain)and large postpartum hemorrhage volume.Reasonable management of weight during pregnancy and prevention and control of postpartum hemorrhage should be strengthened in clinical practice to reduce the incidence of PUR.