ResearchUrogynecologyFactors associated with persistent urinary incontinence
Section snippets
Study population
The Nurses' Health Study was initiated in 1976, when 121,700 female nurses, aged 30-55 years, responded to a mailed questionnaire on their medical history and lifestyle; this information is updated with similar questionnaires every 2 years. Questions about UI were included on the questionnaires in 2000, 2002, 2004, 2006, and 2008; to date, the follow-up rate is approximately 90%. The institutional review board of Brigham and Women's Hospital approved this study, and informed consent was implied
Results
Table 1 shows age-adjusted characteristics of our study population at the initial UI assessment in 2000, separately for women with persistent UI vs no UI during the study period. Compared to women with no UI, women with persistent UI were older, slightly more parous, and more likely to report current use of postmenopausal hormones and prior hysterectomy. In addition, women with persistent UI, on average, had higher BMI and lower physical activity levels compared to women without UI.
In
Comment
In this large cohort of women aged 54-79 years, we found associations of demographic, lifestyle, and health-related factors with persistent UI. Of interest, our study demonstrated that most known risk factors for UI prevalence and incidence were also related to persistent UI. Nonetheless, advancing age, white race, and obesity were very strong factors associated with persistent UI; since most women do not ask their health care providers about UI, these risk factors might indicate women whom
References (19)
- et al.
Dynamic progression of overactive bladder and urinary incontinence symptoms: a systematic review
Eur Urol
(2010) - et al.
Incidence and remission of lower urinary tract symptoms during 12 years after the first delivery: a cohort study
J Urol
(2008) - et al.
Association of age, race, and obstetric history with urinary symptoms among women in the nurses' health study
Am J Obstet Gynecol
(2003) - et al.
Predictors of female urinary incontinence at midlife and beyond
Maturitas
(2010) - et al.
The incidence of urinary incontinence across Asian, black, and white women in the United States
Am J Obstet Gynecol
(2010) - et al.
Talking about incontinence: the first step toward prevention and treatment
JAMA
(2010) - et al.
The prevalence of urinary incontinence and its burden on the quality of life among older adults with Medicare supplement insurance
Qual Life Res
(2011) - et al.
Can we prevent incontinence? ICI-RS 2011
Neurourol Urodyn
(2012) A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women
Neurourol Urodyn
(2008)
Cited by (34)
Physical activity and urinary incontinence during pregnancy and postpartum: A systematic review and meta-analysis
2021, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :There is moderate evidence it increases bone density in adults [8]. Additionally, other publications report that mild to moderate physical activity is associated with a reduction of the prevalence of UI in women [9–13]. Previous systematic reviews have been carried out on physical activity and UI in pregnant and postpartum women, but included studies which often assessed interventions combining exercises for pelvic floor muscle training (PFMT) and another physical activity [14–16].
What is to blame for postnatal pelvic floor dysfunction in primiparous women—Pre-pregnancy or intrapartum risk factors?
2017, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :This issue of PFD in women has been highlighted recently in Europe and the USA as recently as December 2015 [1,2]. In order to identify women at a higher risk of PFD, multiple studies have investigated risk factors (RFs) for PFD and have identified the most significant as high BMI, age, parity, reduced quality of life scores, or features of childbearing such as vaginal delivery, oxytocin use and prolonged second stage of labor [3–8]. However, PFD is a common problem not only in parous women, but also in nulliparous women, and in the majority of them there is multi-compartment involvement [9].
Physical activity and the pelvic floor
2016, American Journal of Obstetrics and GynecologyCitation Excerpt :In a prospective 12 year analysis of women aged 37–54 years in the Nurses’ Health Study, the risk of at least monthly UI decreased with increasing quintiles of moderate PA (adjusted relative risk [RR], 0.89, 0.80, and 0.99 comparing extreme quintiles).35 Furthermore, in this population, lower PA levels were associated with a greater odds of persistent UI at follow-up.36 In older Latino adults, the 1 year incidence of UI was lower (odds ratio, 0.69, 0.50, and 0.95) in those that improved their physical performance score.37
Lifetime physical activity and female stress urinary incontinence
2015, American Journal of Obstetrics and GynecologyNonsurgical Transurethral Radiofrequency Therapy, Laser and Other Interventions for the Treatment of Stress Urinary Incontinence
2023, Textbook of Female Urology and Urogynecology: Clinical Perspectives
The Nurses' Health Study receives funding from the National Institutes of Health (P01 CA87969).
The authors report no conflict of interest.
Cite this article as: Devore EE, Minassian VA, Grodstein F. Factors associated with persistent urinary incontinence. Am J Obstet Gynecol 2013;209:145.e1-6.