TY - JOUR
T1 - Urinary incontinence persisting after childbirth: extent, delivery history and effects in a 12 year longitudinal cohort study
AU - MacArthur, C.
AU - Wilson, D.
AU - Herbison, P.
AU - Lancashire, R.J.
AU - Hagen, S.
AU - Toozs-Hobson, P.
AU - Dean, N.
AU - Glazener, C.
AU - Prolong Study Group
N1 - Non-REF scope: accepted 2015. 17/5/19 DC.
Acceptance from webpage 08/09/19 EL.
PY - 2016/5
Y1 - 2016/5
N2 - Objective To investigate the extent of persistent urinary incontinence (UI) 12 years after birth, and association with delivery-mode history and other factors. Design Twelve-year longitudinal cohort study. Setting Maternity units in Aberdeen, Birmingham, and Dunedin. Population Women who returned questionnaires 3 months and 12 years after index birth. Methods Data on all births over a period of 12 months were obtained from the units and then women were contacted by post. Main outcome measure Persistent UI reported at 12 years, with one or more previous contact. Results Of 7879 women recruited at 3 months, 3763 (48%) responded at 12 years, with 2944 also having responded at 6 years; non-responders had similar obstetric characteristics. The prevalence of persistent UI was 37.9% (1429/3763). Among those who had reported UI at 3 months, 76.4% reported it at 12 years. Women with persistent UI had lower SF12 quality of life scores. Compared with having only spontaneous vaginal deliveries (SVDs), women who delivered exclusively by caesarean section were less likely to have persistent UI (odds ratio, OR 0.42, 95% CI 0.33-0.54). This was not the case in women who had a combination of caesarean section and SVD births (OR 1.01, 95% CI 0.78-1.30). Older age at first birth, greater parity, and overweight/obesity were associated with persistent UI. Of 54 index primiparae with UI before pregnancy, 46 (85.2%) had persistent UI. Conclusions This study, demonstrating that UI persists to 12 years in about three-quarters of women, and that risk was only reduced with caesarean section if women had no other delivery mode, has practice implications. Tweetable abstract A longitudinal study of 3763 women showed a prevalence of persistent UI 12 years after birth of 37.9%.
AB - Objective To investigate the extent of persistent urinary incontinence (UI) 12 years after birth, and association with delivery-mode history and other factors. Design Twelve-year longitudinal cohort study. Setting Maternity units in Aberdeen, Birmingham, and Dunedin. Population Women who returned questionnaires 3 months and 12 years after index birth. Methods Data on all births over a period of 12 months were obtained from the units and then women were contacted by post. Main outcome measure Persistent UI reported at 12 years, with one or more previous contact. Results Of 7879 women recruited at 3 months, 3763 (48%) responded at 12 years, with 2944 also having responded at 6 years; non-responders had similar obstetric characteristics. The prevalence of persistent UI was 37.9% (1429/3763). Among those who had reported UI at 3 months, 76.4% reported it at 12 years. Women with persistent UI had lower SF12 quality of life scores. Compared with having only spontaneous vaginal deliveries (SVDs), women who delivered exclusively by caesarean section were less likely to have persistent UI (odds ratio, OR 0.42, 95% CI 0.33-0.54). This was not the case in women who had a combination of caesarean section and SVD births (OR 1.01, 95% CI 0.78-1.30). Older age at first birth, greater parity, and overweight/obesity were associated with persistent UI. Of 54 index primiparae with UI before pregnancy, 46 (85.2%) had persistent UI. Conclusions This study, demonstrating that UI persists to 12 years in about three-quarters of women, and that risk was only reduced with caesarean section if women had no other delivery mode, has practice implications. Tweetable abstract A longitudinal study of 3763 women showed a prevalence of persistent UI 12 years after birth of 37.9%.
KW - long term
KW - postpartum
KW - risk factors
KW - urinary incontinence
U2 - 10.1111/1471-0528.13395
DO - 10.1111/1471-0528.13395
M3 - Article
VL - 123
SP - 1022
EP - 1029
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
SN - 1470-0328
IS - 6
ER -