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Urinary incontinence between 12 and 24 months postpartum: a cross-sectional study nested in a Brazilian cohort from two cities with different socioeconomic characteristics

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Abstract

Introduction and hypothesis

We aimed to identify the prevalence of urinary incontinence (UI) during the postpartum period (12–24 months) in two cities with different socioeconomic indicators in Brazil (Ribeirão Preto, SP, and São Luís, MA) and to determine associated risk factors.

Methods

A cross-sectional study nested in the Brazilian Ribeirão Preto and São Luís Birth Cohort Studies (BRISA) cohort was conducted in two Brazilian municipalities (Ribeirão Preto, and São Luís). A total of 13,214 women delivered in both cities (2010–2011). We interviewed 3,751 postpartum women in Ribeirão Preto and 3275 in São Luís (2011–2013). Univariate and multivariate analyses were performed to assess factors associated with postpartum UI for each municipality.

Results

The prevalence of self-reported UI at 12–24 months postpartum was 16.3% (611 out of 3,751) in Ribeirão Preto and 11.4% (375 out of 3,275) in São Luís (p < 0.001). The univariate analysis performed at Ribeirão Preto showed that women who were obese, who had diabetes or gestational diabetes and who presented with excessive weight gain during gestation presented an association with postpartum UI. However, only weight gain during pregnancy remained strongly associated with UI on multivariate analysis (p = 0.009; OR 1.041 [1.010–1.073]). On the other hand, in São Luís, no risk factors were associated with postpartum UI at univariate and multivariate analysis.

Conclusions

The prevalence of UI was higher in Ribeirão Preto (higher socioeconomic level) than in São Luís. Weight gain during pregnancy was statistically associated with UI in Ribeirão Preto. No independent variables remained associated in the final model with UI in São Luís.

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References

  1. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.

    PubMed  Google Scholar 

  2. Norton P, Brubaker L. Urinary incontinence in women. Lancet. 2006;367(9504):57–67.

    Article  Google Scholar 

  3. Turner DA, Shaw C, McGrother CW, Dallosso HM, Cooper NJ. The cost of clinically significant urinary storage symptoms for community-dwelling adults in the UK. BJU Int. 2004;93:1246–52.

    Article  CAS  PubMed  Google Scholar 

  4. Sangsawang B, Sangsawang N. Stress urinary incontinence in pregnant women: a review of prevalence, pathophysiology, and treatment. Int Urogynecol J. 2013;24(6):901–12.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Schimpf MO. Postpartum urinary incontinence: asking the right questions. BJOG. 2016;123(7):1229.

    Article  CAS  PubMed  Google Scholar 

  6. Fritel X, Tsegan YE, Pierre F, Saurel-Cubizolles MJ. Association of postpartum depressive symptoms and urinary incontinence. A cohort study. Eur J Obstet Gynecol Reprod Biol. 2016;198:62–7.

    Article  PubMed  Google Scholar 

  7. Fritel X, Ringa V, Quiboeuf E, Fauconnier A. Female urinary incontinence, from pregnancy to menopause: a review of epidemiological and pathophysiological findings. Acta Obstet Gynecol Scand. 2012;91(8):901–10.

    Article  PubMed  Google Scholar 

  8. Espuna-Pons M, Solans-Domenech M, Sanchez E. Double incontinence in a cohort of nulliparous pregnant women. Neurourol Urodyn. 2012;31(8):1236–41.

    Article  PubMed  Google Scholar 

  9. Da Silva AA, Simões VM, Barbieri MA, Cardoso VC, Alves CM, Thomaz EB, et al. A protocol to identify non-classical risk factors for preterm births: the Brazilian Ribeirão Preto and São Luís prenatal cohort (BRISA). Reprod Health. 2014;11(1):79.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Waetjen LE, Xing G, Johnson WO, Melnikow J, Gold EB. Factors associated with seeking treatment for urinary incontinence during the menopausal transition. Obstet Gynecol. 2015;125(5):1071–9.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Barbosa AM, Marini G, Piculo F, Rudge CV, Calderon IM, Rudge MV. Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study. Sao Paulo Med J. 2013;131(2):95–9.

    Article  PubMed  Google Scholar 

  12. Buckley BS, Lapitan MC. Prevalence of urinary incontinence in men, women, and children—current evidence: findings of the fourth international consultation on incontinence. Urology. 2010;76(2):265–70.

    Article  PubMed  Google Scholar 

  13. Thom DH, Rortveit G. Prevalence of postpartum urinary incontinence: a systematic review. Acta Obstet Gynecol Scand. 2010;89(12):1511–22.

    Article  PubMed  Google Scholar 

  14. Quiboeuf E, Saurel-Cubizolles MJ, Fritel X. Trends in urinary incontinence in women between 4 and 24 months postpartum in the EDEN cohort. BJOG. 2016;123(7):1222–8.

    Article  CAS  PubMed  Google Scholar 

  15. MacArthur C, Wilson D, Herbison P, Lancashire RJ, Hagen S, Toozs-Hobson P, et al. Urinary incontinence persisting after childbirth: extent, delivery history, and effects in a 12-year longitudinal cohort study. BJOG. 2016;123(6):1022–9.

    Article  CAS  PubMed  Google Scholar 

  16. Ruiz de Vinaspre Hernandez R, Rubio Aranda E, Tomas Aznar C. Urinary incontinence and weight changes during pregnancy and postpartum: a pending challenge. Midwifery. 2013;29(12):e123–9.

    Article  PubMed  Google Scholar 

  17. Wesnes SL, Hunskaar S, Bo K, Rortveit G. Urinary incontinence and weight change during pregnancy and postpartum: a cohort study. Am J Epidemiol. 2010;172(9):1034–44.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Pitkin RM. Nutritional support in obstetrics and gynecology. Clin Obstet Gynecol. 1976;19(3):489–513.

    Article  CAS  PubMed  Google Scholar 

  19. Berggren EK, Groh-Wargo S, Presley L, Hauguel-de Mouzon S, Catalano PM. Maternal fat, but not lean, mass is increased among overweight/obese women with excess gestational weight gain. Am J Obstet Gynecol. 2016;214(6):745.e1–5.

    Article  Google Scholar 

  20. Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360(5):481–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Ebbesen MH, Hunskaar S, Rortveit G, Hannestad YS. Prevalence, incidence and remission of urinary incontinence in women: longitudinal data from the Norwegian HUNT study (EPINCONT). BMC Urol. 2013;13:27.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Chuang CM, Lin IF, Horng HC, Hsiao YH, Shyu IL, Chou P. The impact of gestational diabetes mellitus on postpartum urinary incontinence: a longitudinal cohort study on singleton pregnancies. BJOG. 2012;119(11):1334–43.

    Article  PubMed  Google Scholar 

  23. Kim C, McEwen LN, Sarma AV, Piette JD, Herman WH. Stress urinary incontinence in women with a history of gestational diabetes mellitus. J Women’s Health. 2008;17(5):783–92.

    Article  Google Scholar 

  24. Tahtinen RM, Auvinen A, Cartwright R, Johnson TM 2nd, Tammela TL, Tikkinen KA. Smoking and bladder symptoms in women. Obstet Gynecol. 2011;118(3):643–8.

    Article  PubMed  Google Scholar 

  25. Tong VT, Farr SL, Bombard J, D’Angelo D, Ko JY, England LJ. Smoking before and during pregnancy among women reporting depression or anxiety. Obstet Gynecol. 2016;128(3):562–70.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Tahtinen RM, Cartwright R, Tsui JF, Aaltonen RL, Aoki Y, Cardenas JL, et al. Long-term impact of mode of delivery on stress urinary incontinence and urgency urinary incontinence: a systematic review and meta-analysis. Eur Urol. 2016;70(1):148–58.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Casey BM, Schaffer JI, Bloom SL, Heartwell SF, McIntire DD, Leveno KJ. Obstetric antecedents for postpartum pelvic floor dysfunction. Am J Obstet Gynecol. 2005;192(5):1655–62.

    Article  PubMed  Google Scholar 

  28. Bo K, Hilde G, Tennfjord MK, Engh ME. Does episiotomy influence vaginal resting pressure, pelvic floor muscle strength and endurance, and prevalence of urinary incontinence 6 weeks postpartum? Neurourol Urodyn. 2017;36(3):683–6.

    Article  PubMed  Google Scholar 

  29. Oliveira LS, Brito LG, Quintana SM, Duarte G, Marcolin AC. Perineal trauma after vaginal delivery in healthy pregnant women. Sao Paulo Med J. 2014;132(4):231–8.

    Article  PubMed  Google Scholar 

  30. Jeffs E, Haszard JJ, Sharp B, Gullam J, Paterson H. Pregnant women lack accurate knowledge of their BMI and recommended gestational weight gain. N Z Med J. 2016;129(1439):37–45.

    PubMed  Google Scholar 

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Acknowledgments

The authors thank to all interviewers from the BRISA cohort study for their assistance in recruiting the participants.

Funding

National Council for Scientific and Technological Development (CNPq), São Paulo State Research Foundation (FAPESP) process no. 08/53593-0 and Maranhão Research Foundation (FAPEMA).

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Authors and Affiliations

  1. Department of Gynaecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

    Pedro Sergio Magnani, Ricardo de Carvalho Cavalli & Luiz Gustavo Oliveira Brito

  2. Department of Paediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

    Heloisa Bettiol & Marco Antonio Barbieri

  3. Department of Public Health, Federal University of Maranhão, São Luís, Brazil

    Antonio Augusto Moura da Silva

  4. Hospital das Clínicas da FMRP-USP, Avenida Bandeirantes, 3900 – 8th floor – Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil

    Luiz Gustavo Oliveira Brito

Authors
  1. Pedro Sergio Magnani
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  2. Heloisa Bettiol
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  3. Antonio Augusto Moura da Silva
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  4. Marco Antonio Barbieri
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  5. Ricardo de Carvalho Cavalli
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  6. Luiz Gustavo Oliveira Brito
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Correspondence to Luiz Gustavo Oliveira Brito.

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Magnani, P.S., Bettiol, H., da Silva, A.A.M. et al. Urinary incontinence between 12 and 24 months postpartum: a cross-sectional study nested in a Brazilian cohort from two cities with different socioeconomic characteristics. Int Urogynecol J 30, 1003–1011 (2019). https://doi.org/10.1007/s00192-019-03907-y

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