Leaking urine prior to pregnancy: a risk factor for postnatal incontinence

The prevalence of 30% for postnatal urinary incontinence is a major women's health issue. The majority of studies to date are retrospective, and evidence about contributing factors is inconsistent.

To identify women at risk for postnatal urinary incontinence following the first pregnancy and birth.

One hundred and twenty four women participated in a longitudinal study. Questionnaires and interviews were conducted at 14, 24 and 38 weeks' gestation and 24-72 h, 6-8 weeks and 6-18 months postnatal. These, along with chart audits for pregnancy, labour and delivery factors and demographics, formed the database for logistic regression.

The only variable to emerge as a key indicator for predicting those women most at risk for developing postnatal urine leakage was a history of urinary leaking prior to the first pregnancy. Women with this history were 4.14 times more at risk of leaking urine 1 year after giving birth than women without previous urine leakage (P = 0.02). There was a pattern of leaking urine across the childbearing experience that suggests some resolution by 12 months regardless of parity. Length of second stage labour and method of delivery were the only labour and delivery variables to show significant differences between leaking and not leaking urine at 12 months postnatal.

Women who leak urine before their first pregnancy can be identified during early antenatal care as those at risk for postnatal urinary incontinence. Further research to test preventive measures is needed.