Abstract
Background: Stress urinary incontinence (SUI) is frequently underrecognized in late pregnancy, with limited tools for effective risk assessment. This study aimed to evaluate the predictive value of clinical and pelvic floor ultrasound parameters for SUI and construct a validated risk model. Methods: Clinical, obstetric, and pelvic floor ultrasound findings were collected from a total of 521 women in late pregnancy who were enrolled in the study. Based on follow-up results, participants were categorized into SUI and non-SUI groups. Logistic regression analyses were used to identify independent risk factors for SUI, which were incorporated into a nomogram. Results: Four independent predictors were identified: vaginal delivery history (odds ratio [OR] = 2.320), bladder neck funneling (OR = 2.349), bladder neck descent (OR = 1.891), and pubococcygeus muscle contraction strain rate (OR < 0.001). The nomogram achieved an AUC of 0.817 (95% CI: 0.770-0.863) in the training set and 0.761 (95% CI: 0.677-0.845) in the test set. Conclusions: The nomogram based on clinical and pelvic floor ultrasound parameters accurately predicts the risk of SUI during late pregnancy, offering a useful tool for early identification and personalized management.