Association between waist-to-height ratio and postpartum urinary incontinence

Obesity is an established and variable risk factor for postpartum urinary incontinence. However, the available anthropometric measurements are not comprehensive. We hypothesized that waist-to-height ratio (WHTR), which is a good indicator of abdominal adiposity, would be associated with postpartum urinary incontinence.

For this cross-sectional study, we recruited 1,137 women who were invited to visit our hospital outpatient service for a pelvic floor examination. Anthropometric indexes were determined using standardized methods. A Peritron perineometer was used for the pelvic floor examinations. An internationally validated questionnaire was used to evaluate urinary incontinence. Odds ratios and 95 % confidence intervals were estimated using multiple logistic regression models.

Increased body mass index (BMI), WHTR and waist circumference (WC) showed highly significant associations with an increased risk of stress and mixed urinary incontinence. When BMI and WHTR were included in the same model, the risk of mixed urinary incontinence in the "take action" group (WHTR ≥0.6) was 4.3 times greater than the risk in the healthy reference group. After adjusting for BMI and WC, WHTR was independently associated with mixed urinary incontinence. Specifically, the risk of mixed urinary incontinence in the "take action" group (WHTR ≥0.6) was 6.58 times greater than the risk in the healthy reference group.

Determining WHTR may be an effective means of evaluating the risk of mixed urinary incontinence in women with abdominal obesity.