Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors
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Few studies have examined associations of prepregnancy urinary incontinence (UI).
Multicentre prospective pregnancy cohort study (n = 1,507) using standardised measures to assess frequency and severity of UI.
Prevalence of UI increased from 10.8% in the 12 months before the index pregnancy to 55.9% in the third trimester. Stress incontinence (36.9%) and mixed incontinence (13.1%) were more common during pregnancy than urge incontinence alone (5.9%). UI before pregnancy was associated with childhood enuresis (adjusted odds ratio (AdjOR) = 2.4, 95% confidence interval (CI) 1.6–3.4), higher maternal body mass index (AdjOR = 2.3, 95% CI 1.4–3.8), and previous miscarriages or terminations (AdjOR = 1.6, 95% CI 1.1–2.3). The strongest predictor of incident UI in pregnancy was occasional leakage (less than once a month) before pregnancy (AdjOR = 3.6, 95% CI 2.8–4.7).
Further research is needed to elucidate the complex interplay of prepregnancy and pregnancy-related factors in the aetiology of UI in nulliparous women.
KeywordsChildhood enuresis Nulliparous Pregnancy Prospective cohort study Urinary incontinence
Body mass index
Computer-assisted telephone interview
We are grateful to members of the Maternal Health Study Collaborative Group (Jane Gunn, Kelsey Hegarty, Shaun Brennecke, Peter Wein, and Jane Yelland) who contributed to the design of study instruments and/or interpretation of data presented in the paper, to Deirdre Gartland who provided invaluable assistance with data cleaning, and to members of the Maternal Health Study research team who have contributed to data collection and coding (Marita Baum, Liesje Brice, Mary Conellan, Maggie Flood, Kay Paton, Renee Paxton, Susan Perlen, Martine Spaull, and Hannah Woolhouse).
This research was supported by a project grant from the Australian National Health and Medical Research Council (ID191222, Melbourne, Australia), a VicHealth Public Health Research Fellowship (2002–2006), and National Health and Medical Research Council Career Development Award (ID491205, 2008–2011) awarded to Stephanie J Brown.
Conflicts of interest
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