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Is there an association between physical activity and lower urinary tract symptoms in adolescent girls? Results from the Avon Longitudinal Study of Parents and Children

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Abstract

Introduction and hypothesis

Lower urinary tract symptoms (LUTS) are common among adolescent girls. Physical activity (PA) has been implicated as both a risk (high-impact PA) and protective factor (low-impact, moderate to vigorous intensity PA) for LUTS in adult women, but its role in adolescent girls is unclear. This study investigated the prospective association between physical activity and LUTS risk in adolescent girls.

Methods

The sample comprised 3,484 female participants in the Avon Longitudinal Study of Parents and Children. Multivariate logistic regression models were used to examine daily minutes of moderate to vigorous PA (MVPA) at ages 11 and 15 years in relation to LUTS at ages 14 and 19 respectively. MVPA was assessed by 7-day accelerometer data. LUTS were assessed by questionnaire. MVPA were analyzed as continuous (minutes/day) and categorical variables (<10th percentile, 10–89th percentile, ≥90th percentile).

Results

Prevalence of LUTS ranged from 2.0% for bedwetting to 9.5% for nocturia at age 14 and from 2.0% for straining to urinate to 35.5% for interrupted urine flow at age 19. Physical activity was not associated with LUTS at either time-point.

Conclusions

Given the prevalence of LUTS in female adolescent populations, although this study did not find an association with accelerometer-measured MVPA, other aspects of PA that may serve as risk or protective factors deserve investigation.

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Data Availability

The informed consent obtained from ALSPAC participants does not allow the data to be made freely available through any third party maintained public repository. However, data used for this submission can be made available on request to the ALSPAC Executive. The ALSPAC data management plan describes in detail the policy regarding data sharing, which is through a system of managed open access. Full instructions for applying for data access can be found here: http://www.bristol.ac.uk/alspac/researchers/access/. The ALSPAC study website contains details of all the data that are available (http://www.bristol.ac.uk/alspac/researchers/our-data/).

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Acknowledgements

We are extremely grateful to all the families who took part in the ALSPAC study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium Research Centers and Investigators: Loyola University Chicago, Maywood, IL, USA (U01DK106898); multi-principal investigators: Linda Brubaker, Elizabeth R. Mueller; investigators: Marian Acevedo-Alvarez, Colleen M. Fitzgerald, Cecilia T. Hardacker, Jeni Hebert-Beirne. Northwestern University—Chicago, IL, USA (U01DK126045): multi-principal investigators: James W. Griffith, Kimberly Sue Kenton, Melissa Simon; investigator: Oluwateniola Brown, Julia Geynisman-Tan, Margaret Mueller. University of Alabama at Birmingham, Birmingham, AL, USA (U01DK106858): principal investigators: Alayne D. Markland, Camille P. Vaughan; investigators: Tamera Coyne-Beasley, Kathryn L. Burgio, Cora E. Lewis, Beverly Rosa Williams. University of California San Diego, La Jolla, CA, USA (U01DK106827): principal investigator: Emily S. Lukacz; investigators: Sheila Gahagan, D. Yvette LaCoursiere, Jesse Nodora. University of Michigan—Ann Arbor, MI, USA (U01DK106893): principal investigator: Lisa Kane Low; investigators: Janis M. Miller, Abby Smith. University of Minnesota (Scientific and Data Coordinating Center), Minneapolis, MN, USA (U24DK106786): multi-principal investigators: Gerald McGwin, Jr., Kyle D. Rudser; investigators: Sonya S. Brady, Haitao Chu, Cynthia S. Fok, Bernard L. Harlow, Peter Scal, Todd Rockwood. University of Pennsylvania, Philadelphia, PA, USA (U01DK106892): multi-principal investigators: Diane K. Newman, Ariana L. Smith; investigators: Amanda Berry, Andrea Bilger, Terri H. Lipman, Heather Klusaritz, Ann E. Stapleton, Jean F. Wyman. Washington University in St. Louis, Saint Louis, MO, USA (U01DK106853): principal investigator: Siobhan Sutcliffe; investigators: Aimee S. James, Jerry L. Lowder, Melanie R. Meister. Yale University, New Haven, CT, USA (U01DK106908): principal investigator: Leslie M. Rickey: investigators: Deepa R. Camenga, Shayna D. Cunningham. Steering Committee Chair: Linda Brubaker, UCSD, San Diego, CA, USA (January 2021–). NIH Program Office: National Institute of Diabetes and Digestive and Kidney Diseases, Division of Kidney, Urologic, and Hematologic Diseases, Bethesda, MD, USA. NIH Project Scientist: Julia Barthold

Funding

Funding for the ALSPAC study was provided by the UK Medical Research Council and the Wellcome Trust (grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). This publication is the work of the authors and the authors will serve as guarantors for the contents of this paper. This work was also supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health (NIH) by cooperative agreements (grants U24DK106786, U01 DK106853, U01 DK106858, U01 DK106898, U01 DK106893, U01 DK106827, U01 DK106908, U01 DK106892, U01 DK126045). Additional funding from: National Institute on Aging, NIH Office of Research on Women’s Health. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Urology, Loyola University Chicago, Chicago, IL, USA

    Colleen M. Fitzgerald

  2. Department of Public Health Sciences, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT, 06030, USA

    Shayna D. Cunningham

  3. Division of Urology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Amanda Berry

  4. Department of Pediatrics, University of California San Diego, La Jolla, CA, USA

    Sheila Gahagan

  5. Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK

    Carol Joinson

  6. Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, MN, USA

    Sarah Lindberg

  7. Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Diane K. Newman

  8. Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA

    Kathryn H. Schmitz

  9. Division of Urology, Perelman School of Medicine, University of Pennsylvania Health System, Philadelphia, PA, USA

    Ariana L. Smith

  10. Division of Public Health Sciences, Department of Surgery, and the Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA

    Siobhan Sutcliffe

  11. Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City, TN, USA

    David A. Shoham

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  1. Colleen M. Fitzgerald
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  6. Sarah Lindberg
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  7. Diane K. Newman
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Consortia

Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium

  • Linda Brubaker
  • , Elizabeth R. Mueller
  • , Marian Acevedo-Alvarez
  • , Cecilia T. Hardacker
  • , Jeni Hebert-Beirne
  • , James W. Griffith
  • , Kimberly Sue Kenton
  • , Melissa Simon
  • , Oluwateniola Brown
  • , Julia Geynisman-Tan
  • , Margaret Mueller
  • , Alayne D. Markland
  • , Camille P. Vaughan
  • , Tamera Coyne-Beasley
  • , Kathryn L. Burgio
  • , Cora E. Lewis
  • , Beverly Rosa Williams
  • , Emily S. Lukacz
  • , Heather Klusaritz
  • , Yvette LaCoursiere
  • , Jesse Nodora
  • , Lisa Kane Low
  • , Janis M. Miller
  • , Abby Smith
  • , Gerald McGwin Jr.
  • , Kyle D. Rudser
  • , Sonya S. Brady
  • , Haitao Chu
  • , Cynthia S. Fok
  • , Bernard L. Harlow
  • , Peter Scal
  • , Todd Rockwood
  • , Andrea Bilger
  • , Terri H. Lipman
  • , Ann E. Stapleton
  • , Jean F. Wyman
  • , Aimee S. James
  • , Jerry L. Lowder
  • , Melanie R. Meister
  • , Leslie M. Rickey
  • , Deepa R. Camenga
  •  & Julia Barthold

Contributions

C.M. Fitzgerald: project development, interpretation of findings, manuscript writing, manuscript editing; S.D. Cunningham: interpretation of findings, manuscript writing, manuscript editing; A. Berry: interpretation of findings, manuscript writing, manuscript editing; S. Gahagan: interpretation of findings, manuscript writing, manuscript editing; C. Joinson: interpretation of findings, manuscript editing. S. Lindberg: data analysis, manuscript writing, manuscript editing; D.K. Newman: interpretation of findings, manuscript writing, manuscript editing; K.H. Schmitz: interpretation of findings, manuscript editing. A.L. Smith: project development, interpretation of findings, manuscript editing; S. Sutcliffe: project development; interpretation of findings, manuscript editing; D.A. Shoham: project development, data analysis, interpretation of findings, manuscript writing, manuscript editing.

Corresponding author

Correspondence to Shayna D. Cunningham.

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Conflicts of interest

C.M. Fitzgerald: Royalties from UpToDate and Expert Witness. The other authors have no conflicts of interest to the subject matter of the manuscript.

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Fitzgerald, C.M., Cunningham, S.D., Berry, A. et al. Is there an association between physical activity and lower urinary tract symptoms in adolescent girls? Results from the Avon Longitudinal Study of Parents and Children. Int Urogynecol J 34, 2995–3003 (2023). https://doi.org/10.1007/s00192-023-05639-6

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