Lower urinary tract symptoms in primiparous women before and during pregnancy

Lower urinary tract symptoms (LUTS), in particular urinary incontinence (UI), commonly develops during pregnancy or following delivery. This study was conducted to investigate the prevalence of the LUTS before and during pregnancy, and to demonstrate the relationships between various obstetric parameters and UI.

For this observational study, 1,501 consecutive primiparae who delivered at ≥ 36 gestational weeks were recruited in a tertiary hospital. A urogynecological questionnaire was used to assess the prevalence of LUTS before and during pregnancy. The relationships between various obstetric parameters and UI were analyzed.

Prevalence of LUTS increased over the course of pregnancy. The most commonly reported LUTS symptoms, regardless of pregnancy trimester, were nocturia (51.1%) and frequency (40.3%), UI (37.5%), urgency (31.1%), incomplete bladder emptying (26.3%), straining (15.3%), and voiding difficulty (14.5%). Stress UI (SUI) (26.7%) was more common during pregnancy than mixed UI (6.1%) or urge UI (4.7%). Women with a prepregnancy BMI >30 were at increased risk of developing de novo SUI during pregnancy. Urge incontinence during pregnancy was associated with smoking.

The prevalence of LUTS generally increased with gestational age. UI during pregnancy was associated with prepregnancy BMI and smoking.