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<b>Objective:</b> To investigate the incidence of urinary incontinence during pregnancy and within 6 months postpartum among primiparous women with singleton pregnancy, and to study the risk factors for postpartum urinary incontinence in these women. <b>Methods:</b> A bidirectional cohort study was conducted, enrolling 426 primiparous women with singleton pregnancy who were hospitalized for delivery at Wenzhou Central Hospital between September 2022 and March 2023. According to the mode of delivery, the participants were divided into three groups: the elective cesarean section group (<i>n</i>=116), the intrapartum cesarean section group (<i>n</i>=92), and the vaginal delivery group (<i>n</i>=218). The incidence of urinary incontinence was assessed during pregnancy and at 42 days, 3 months, and 6 months postpartum in the three groups. Baseline characteristics, intrapartum data, and postpartum pelvic floor rehabilitation data were collected. Binary logistic regression analysis was performed to identify the risk and protective factors for postpartum urinary incontinence in primiparous women with singleton pregnancy. <b>Results:</b> (1) Among the 426 primiparous women with singleton pregnancy, the incidence of urinary incontinence during pregnancy and at 42 days, 3 months, and 6 months postpartum was 27.7% (118/426), 20.2% (86/426), 16.2% (69/426), and 14.3% (61/426), respectively. (2) At 42 days, 3 months, and 6 months postpartum, the incidence of urinary incontinence in the vaginal delivery group were 6.430, 5.709, and 6.981 times higher, respectively, than those in the elective cesarean section group (all <i>P</i><0.001). Women with urinary incontinence during pregnancy had a significantly higher incidence of urinary incontinence at 42 days, 3 months, and 6 months postpartum than those without urinary incontinence during pregnancy, with relative risks of 3.605, 4.398, and 3.362, respectively (all <i>P</i><0.001). In the elective cesarean section group, women aged≥35 years had a significantly higher incidence of urinary incontinence at 42 days postpartum than those aged<35 years (relative risk: 7.721, <i>P</i><0.05). Compared with the elective cesarean section group, the intrapartum cesarean section group showed higher incidence of urinary incontinence at 42 days, 3 months, and 6 months postpartum; however, after adjustment for confounding factors using binary logistic regression analysis, no significant differences were observed between the two groups at three time points (all <i>P</i>>0.05). (3) Among women with urinary incontinence at 42 days postpartum, postpartum pelvic floor rehabilitation was identified as a protective factor against urinary incontinence at 6 months postpartum (<i>OR</i>=0.885,95%<i>CI</i>: 0.806-0.971; <i>P</i><0.05). In contrast, among women without urinary incontinence at 42 days postpartum, postpartum pelvic floor rehabilitation had no significant effect on urinary incontinence at 6 months postpartum (<i>P</i>>0.05). <b>Conclusions:</b> The incidence of urinary incontinence in primiparous women with singleton pregnancy is significantly higher during pregnancy than postpartum. Risk factors for postpartum urinary incontinence in primiparous women with singleton pregnancy include vaginal delivery, urinary incontinence during pregnancy, and maternal age≥35 years at delivery. Elective cesarean section is a protective factor against postpartum urinary incontinence in primiparous women with singleton pregnancy. Intrapartum cesarean section may not increase the incidence of postpartum urinary incontinence. Postpartum pelvic floor rehabilitation training has a therapeutic effect on subsequent urinary incontinence in women who have urinary incontinence at 42 days postpartum.