Urinary incontinence 4 and 12 years after first delivery: Risk factors associated with prevalence, incidence, remission, and persistence in a cohort of 236 women

Authors

  • Anne-Cécile Pizzoferrato,

    1. INSERM, UMR S953, Epidemiological research unit on perinatal health and women's' and children's health, Paris, France
    2. Department of Gynaecology, Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France
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  • Arnaud Fauconnier,

    1. Department of Gynaecology, Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France
    2. Research unit EA7285, Risk, safety in clinical medicine for women, perinatal health, Université Versailles St-Quentin, Montigny-le-Bretonneux, France
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  • Emeline Quiboeuf,

    1. INSERM, UMR S953, Epidemiological research unit on perinatal health and women's' and children's health, Paris, France
    2. University Hospital of La Réunion, Saint-Denis, France
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  • Karine Morel,

    1. University Hospital of La Réunion, Saint-Denis, France
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  • Jean-Patrick Schaal,

    1. University Hospital Saint-Jacques, Franche-Comté University, Besançon, France
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  • Xavier Fritel

    Corresponding author
    1. Poitiers University, INSERM CIC802, University Hospital of Poitiers, Poitiers, France
    2. INSERM, CESP Centre for Research in Epidemiology and Population Health, U1018, Gender, Sexual and Reproductive Health Team, Univ Paris-Sud, UMRS 1018, Kremlin-Bicêtre, France; Institut National des Etudes Démographiques, Paris, France
    • Correspondence to: Prof. Xavier Fritel, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, CHU de Poitiers, 2 rue de la Milétrie, F-86000 Poitiers, France. E-mail: xavier.fritel@univ-poitiers.fr

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  • Contribution to authorship: A.C.P. contributed to analysis and interpretation of data and article writing. X.F. contributed to the conception of the study, the design and the interpretation of data and article writing. K.M. contributed to data management, A.F. contributed to analysis and interpretation of data and revision of the article and E.Q. to data interpretation and revision of the manuscript. J.P.S. contributed to conception of the initial study.
  • Disclosure of interests: We have no direct or indirect commercial financial incentive associated with publication of the article.
  • Ethical approval: Our work complies with French statutes and regulations, which authorize epidemiological surveys without advance approval of an ethics committee. Our survey involved no intervention and is thus excluded from the French statute on biomedical research (LoiHuriet-Serusclat, dated 20 December 1998). We complied with all French statutes concerning data about the subjects, confidentiality, and restrictions (e.g., no religious or racial data). Informed consent was obtained from each responding woman. The Ethical Review Committee “Comité d'Ethique de la Recherche en Obstétrique et Gynécologie” of the French college of Gynecologists and Obstetricians has examined the research and found it to comply with generally accepted scientific principles and medical research ethical standards (CEROG-2009-022).
  • Funding: We had no exterior funding for this work.
  • Mickey Karram led the peer-review process as the Associate Editor responsible for the paper.

Abstract

Aims

Our aim was to study risk factors associated with prevalence, incidence, and remission of UI 4 and 12 years after first delivery.

Methods

Seven hundred seventy-four nulliparous women who gave birth in 1996 in two French maternity units at term received a questionnaire about their urinary symptoms in 2000 and again in 2008. Two hundred thirty-six women returned a questionnaire about UI 4 and 12 years after first delivery. Four groups of women were built: (A) women continent 4 and 12 years after first delivery; (B) women continent at 4 and incontinent at 12 years; (C) women incontinent at 4 and continent at 12 years; and (D) women incontinent at 4 and 12 years. Multivariate logistic regressions were used to determine risk factors of UI prevalence (groups B + D vs. A + C), incidence (B vs. A), remission (C vs. D), and onset of UI (D vs. B).

Results

Factors associated with UI 12 years after first pregnancy were: BMI (OR = 1.17 [95%CI: 1.04–1.32], by 1 kg/m2) and increasing BMI (1.43 [1.19–1.73]), first child's weight (1.08 [1.001–1.16], by 100 g) and UI during first pregnancy (3.77 [1.83–7.76]). Factors associated with UI incidence were age at first delivery (0.86 [0.75–0.98]) and high BMI (1.24 [1.05–1.45]). Increasing BMI, UI during first pregnancy, and heavy first child reduce the likelihood of UI remission (0.37 [0.20–0.68], 0.11 [0.02–0.63], and 0.73[0.59–0.91], respectively).

Conclusions

UI during first pregnancy could be indicative of individual susceptibility to UI. Obesity appears to be a modifiable factor for remission of UI in women. Neurourol. Urodynam. 33:1229–1234, 2014. © 2013 Wiley Periodicals, Inc.

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