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

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Abstract

Introduction

Few studies have examined associations of prepregnancy urinary incontinence (UI).

Methods

Multicentre prospective pregnancy cohort study (n = 1,507) using standardised measures to assess frequency and severity of UI.

Results

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).

Conclusions

Further research is needed to elucidate the complex interplay of prepregnancy and pregnancy-related factors in the aetiology of UI in nulliparous women.

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Abbreviations

BMI:

Body mass index

CATI:

Computer-assisted telephone interview

OR:

Odds ratio

UI:

Urinary incontinence

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Acknowledgements

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).

Funding

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

None.

Author information

Authors and Affiliations

  1. Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Parkville, P.O. Box 911, Melbourne, Victoria, 3052, Australia

    Stephanie J. Brown, Ellie A. McDonald & Ann H. Krastev

  2. Department of General Practice and School of Population Health, University of Melbourne, Melbourne, Australia

    Stephanie J. Brown

  3. Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Melbourne, Australia

    Susan Donath

  4. Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK

    Christine MacArthur

Authors
  1. Stephanie J. Brown
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  2. Susan Donath
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  3. Christine MacArthur
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  4. Ellie A. McDonald
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  5. Ann H. Krastev
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Corresponding author

Correspondence to Stephanie J. Brown.

Appendix: survey items assessing urinary incontinence

Appendix: survey items assessing urinary incontinence

  1. 1.

    Since the start of your current pregnancy have you ever leaked even small amounts of urine:

  2. (a)

    when you coughed, laughed or sneezed, or did physical exercise

  3. (b)

    when you were on the way to the toilet

  4. (c)

    when you had to wait to use the toilet

  5. (d)

    if you did not go to the toilet immediately?

(0 = never, 1 = less than once a month, 2 = one or several times a month, 3 = one or several times a week, 4 = every day)

  1. 2.

    When you leak urine, is it... drops or just a little, more like a trickle, or more than a trickle?

(1 = drops or just a little, 2 = more like a trickle, 3 = more than a trickle)

Severity index for urinary incontinence: The total score is the highest individual score on questions 1a to 1d multiplied by the score for question 2 (0 = continent, 1–2 = slight, 3–6 = moderate, >6 = severe)

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Brown, S.J., Donath, S., MacArthur, C. et al. Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors. Int Urogynecol J 21, 193–202 (2010). https://doi.org/10.1007/s00192-009-1011-x

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  • DOI: https://doi.org/10.1007/s00192-009-1011-x

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