Relationship between lower urinary system symptoms and urinary incontinence in women with gestational diabetes

The aim of this study was to evaluate the association between gestational diabetes mellitus and the severity and impact of lower urinary tract symptoms and urinary incontinence on quality of life in pregnant women.

This case-control study enrolled 500 pregnant women (251 with gestational diabetes mellitus; 249 healthy controls) between 30 and 38 weeks' gestation. Women completed the International Consultation on Incontinence Questionnaire-Short Form, Urogenital Distress Inventory-Short Form, Incontinence Impact Questionnaire-Short Form, and Incontinence Severity Index. Sociodemographic, obstetrics, and anthropometric data were also collected. Multivariable logistic regression analyses were performed to examine the independent association between gestational diabetes mellitus and lower urinary tract symptoms and urinary incontinence.

The gestational diabetes mellitus group exhibited a significantly higher mean age compared to the control group (p<0.001). Pre-pregnancy body mass index and body mass index during pregnancy were also significantly elevated in the gestational diabetes mellitus group (p<0.001). The median gestational weight gain was significantly greater in the gestational diabetes mellitus group (p=0.027). Women with gestational diabetes mellitus demonstrated significantly elevated scores in International Consultation on Incontinence Questionnaire-Short Form, Urogenital Distress Inventory-6, Incontinence Impact Questionnaire-7, and Incontinence Severity Index (p<0.001 for all). After adjusting for age, pre-pregnancy body mass index, body mass index during pregnancy, and gestational weight gain in multivariable logistic regression models, gestational diabetes mellitus remained independently associated with increased UI risk (adjusted OR 2.34, 95%CI 1.56-3.51, p<0.001).

Gestational diabetes mellitus is significantly associated with increased severity of lower urinary tract symptoms and urinary incontinence, as well as a greater negative impact on quality of life during pregnancy. Routine systematic screening for lower urinary tract symptoms and urinary incontinence may be considered for all pregnant women with gestational diabetes mellitus, with early implementation of preventive interventions including supervised pelvic floor muscle training programs.