International Urogynecology Journal

, Volume 21, Issue 2, pp 193–202 | Cite as

Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors

  • Stephanie J. Brown
  • Susan Donath
  • Christine MacArthur
  • Ellie A. McDonald
  • Ann H. Krastev
Original Article



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.


Childhood enuresis Nulliparous Pregnancy Prospective cohort study Urinary incontinence 



Body mass index


Computer-assisted telephone interview


Odds ratio


Urinary incontinence



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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Copyright information

© The International Urogynecological Association 2009

Authors and Affiliations

  • Stephanie J. Brown
    • 1
    • 2
  • Susan Donath
    • 3
  • Christine MacArthur
    • 4
  • Ellie A. McDonald
    • 1
  • Ann H. Krastev
    • 1
  1. 1.Healthy Mothers Healthy Families Research GroupMurdoch Childrens Research InstituteMelbourneAustralia
  2. 2.Department of General Practice and School of Population HealthUniversity of MelbourneMelbourneAustralia
  3. 3.Clinical Epidemiology and Biostatistics UnitMurdoch Childrens Research InstituteMelbourneAustralia
  4. 4.Department of Public Health, Epidemiology and BiostatisticsUniversity of BirminghamBirminghamUK

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