The onset, recurrence and associated obstetric risk factors for urinary incontinence in the first 18 months after a first birth: an Australian nulliparous cohort study

D Gartland, S Donath, C MacArthur, S J Brown

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    36 Citations (Scopus)

    Abstract

    OBJECTIVE: To investigate the contribution of obstetric risk factors to persistent urinary incontinence (UI) between 4 and 18 months postpartum.

    DESIGN: Prospective pregnancy cohort.

    SETTING: Six metropolitan public hospitals in Victoria, Australia.

    SAMPLE: A total of 1507 nulliparous women recruited to the Maternal Health Study in early pregnancy (≤24 weeks of gestation).

    METHODS: Data from hospital records and self-administered questionnaires/telephone interviews at ≤24 and 30-32 weeks of gestation and at 3, 6, 9, 12 and 18 months postpartum analysed using logistic regression.

    MAIN OUTCOME MEASURES: Persistent UI 4-18 months postpartum in women continent before pregnancy.

    RESULTS: Of the women who were continent before pregnancy, 44% reported UI 4-18 months postpartum, and 25% reported persistent UI (symptoms at multiple follow ups). Compared with spontaneous vaginal birth, women who had a caesarean before labour (adjusted odds ratio [aOR] 0.4, 95% confidence interval [95% CI] 0.2-0.9), in first-stage labour (aOR 0.4, 95% CI 0.2-0.6) or in second-stage labour (aOR 0.4, 95% CI 0.2-1.0) were less likely to report persistent UI 4-18 months postpartum. Prolonged second-stage labour in women who had an operative vaginal birth was associated with increased likelihood of UI (aOR 2.5, 95% CI 1.3-4.6). Compared with women who were continent in pregnancy, women reporting UI in pregnancy had a seven-fold increase in odds of persistent UI (aOR 7.4, 95% CI 5.1-10.7).

    CONCLUSIONS: Persistent UI is common after childbirth and is more likely following prolonged labour in combination with operative vaginal birth. The majority of women reporting persistent UI at 4-18 months postpartum also experienced symptoms in pregnancy.

    Original languageEnglish
    Pages (from-to)1361-9
    Number of pages9
    JournalBJOG: An International Journal of Obstetrics & Gynaecology
    Volume119
    Issue number11
    DOIs
    Publication statusPublished - Oct 2012

    Bibliographical note

    © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

    Keywords

    • Adolescent
    • Adult
    • Birth Order
    • Cesarean Section
    • Female
    • Humans
    • Middle Aged
    • Parity
    • Postpartum Period
    • Pregnancy
    • Prospective Studies
    • Puerperal Disorders
    • Questionnaires
    • Recurrence
    • Risk Factors
    • Urinary Incontinence
    • Victoria
    • Young Adult

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