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The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort
1Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. stian.langeland@isf.uib.no
Objective:
The objectives of this study were to investigate prevalence of urinary incontinence at 6 months postpartum and to study how continence status during pregnancy and mode of delivery influence urinary incontinence at 6 months postpartum in primiparous women.
Design:
Cohort study.
Setting:
Pregnant women attending routine ultrasound examination were recruited to the Norwegian Mother and Child Cohort Study (MoBa).
Population:
A total of 12,679 primigravidas who were continent before pregnancy.
Methods:
Data are from MoBa, conducted by the Norwegian Institute of Public Health. Data are based on questionnaires answered at week 15 and 30 of pregnancy and 6 months postpartum.
Main Outcome Measures:
Urinary incontinence 6 months postpartum is presented as proportions, odds ratios and relative risks (RRs).
Results:
Urinary incontinence was reported by 31% of the women 6 months after delivery. Compared with women who were continent during pregnancy, incontinence was more prevalent 6 months after delivery among women who experienced incontinence during pregnancy (adjusted RR 2.3, 95% CI 2.2-2.4). Adjusted RR for incontinence after spontaneous vaginal delivery compared with elective caesarean section was 3.2 (95% CI 2.2-4.7) among women who were continent and 2.9 (95% CI 2.3-3.4) among women who were incontinent in pregnancy.
Conclusion:
Urinary incontinence was prevalent 6 months postpartum. The association between incontinence postpartum and mode of delivery was not substantially influenced by incontinence status in pregnancy. Prediction of a group with high risk of incontinence according to mode of delivery cannot be based on continence status in pregnancy.
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