Prevalence, potential risk factors, and symptomatic bother of lower urinary tract symptoms during and after pregnancy

Nationwide prospective studies of lower urinary tract symptoms (LUTS) during and after pregnancy have never been conducted in mainland China. A prospective longitudinal study was performed to evaluate the association of pregnancy and delivery on LUTS in a representative sample of primiparous Chinese women.

A national survey on urinary incontinence (UI) was conducted in 10,098 pregnant females during late pregnancy (37 to 42 weeks of gestation) and at 6 weeks postpartum.in seven administrative regions of China from September 2007 to May 2009. No intervention was implemented. International Consultation on Incontinence Questionnaire Female Lower Urinary tract Symptoms Module (ICIQ-FLUTS) was administered. The participants were asked about the presence of individual LUTS and rated their symptom bother. Data were analyzed by descriptive statistics, Chi-square tests, and multivariate logistic regression.

Among all participants (mean ± SD maternal age 26.44 ± 3.97 years), the most commonly reported storage LUTS during pregnancy were nocturia (72.3%) and frequency (43.9%). LUTS were much less prevalent after childbirth than during pregnancy. Moderate to severe bother was more common during than after pregnancy. Compared with vaginal delivery (VD), cesarean section (CS) was a protective factor against voiding LUTS (AOR (adjusted odd ration), 0.66; 95% CI, 0.52-0.82) and storage LUTS (AOR, 0.74; 95% CI, 0.66-0.83).

LUTS were much more prevalent during than after pregnancy, with nocturia and frequency being the most prevalent. Moderate or severe bother was more common during pregnancy than after pregnancy. CS was associated with a decreased prevalence both of storage and voiding LUTS after delivery.