Stress urinary incontinence 4 years after the first delivery: a retrospective cohort survey

Authors

  • Xavier Fritel,

    Corresponding author
    1. From the Service de Gynécologie et Obstétrique, Hôpital Rothschild AP-HP, Université Pierre-et-Marie-Curie, and
      *Xavier Fritel
      Gynécologie & Obstétrique
      CHD Félix Guyon
      97405 Saint-Denis cedex, Réunion
      France
      e-mail: x-fritel@chd-fguyon.fr
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  • Arnaud Fauconnier,

    1. INSERM Unité 149, Recherches épidémiologiques en santé périnatale et santé des femmes, Paris, France
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  • Caroline Levet,

    1. From the Service de Gynécologie et Obstétrique, Hôpital Rothschild AP-HP, Université Pierre-et-Marie-Curie, and
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  • Jean-Louis Bénifla

    1. From the Service de Gynécologie et Obstétrique, Hôpital Rothschild AP-HP, Université Pierre-et-Marie-Curie, and
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*Xavier Fritel
Gynécologie & Obstétrique
CHD Félix Guyon
97405 Saint-Denis cedex, Réunion
France
e-mail: x-fritel@chd-fguyon.fr

Abstract

Background.  Our aim was to estimate the prevalence of stress urinary incontinence 4 years after the first delivery and analyze its risk factors.

Methods.  A retrospective cohort survey was conducted in a French university hospital. The 669 primiparous women who delivered in our department in 1996 a singleton in a vertex position between 37 and 41 weeks of amenorrhea were included. A mailed questionnaire was sent 4 years after the indexed delivery. The main outcome measure was stress urinary incontinence 4 years after the first delivery.

Results.  Three hundred and seven women replied, 274 had moved and 88 did not respond. Four years after the first delivery, prevalence of stress urinary incontinence was 29% (89/307). According to multiple logistic regression analysis, the independent risk factors were urine leakage before the first pregnancy [odds ratio (OR) 18.7; 95% confidence interval (CI) 3.6–96.4], urine leakage during the first pregnancy (OR 2.5; 95% CI 1.3–4.8), duration of first labor ≥ 8 h (OR 3.1; 95% CI 1.7–5.7), mother's age > 30 years at the first delivery (OR 2.4; 95% CI 1.4–4.2) and cesarean section at the first delivery (OR 0.3; 95% CI 0.1–0.9).

Conclusion.  Our results suggest that stress urinary incontinence after pregnancy arises from a multifactorial condition. The main risk factors are: age, previous incontinence (before or during the first pregnancy), prolonged labor and vaginal delivery.

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