General Obstetrics and Gynecology
Association of age, race, and obstetric history with urinary symptoms among women in the Nurses' Health Study☆

https://doi.org/10.1067/S0002-9378(03)00361-2Get rights and content

Abstract

OBJECTIVE: The purpose of this study was to better understand associations among age, race, obstetric history, and urinary incontinence in women.

STUDY DESIGN: Race and obstetric history were assessed through the use of biennial mailed questionnaires from 1976 to 1996 among participants of the Nurses' Health Study. In 1996, 83,168 women aged 50 to 75 years reported their frequency of leaking urine and quantity leaked. We used logistic regression to calculate multivariate-adjusted odds ratios and 95% CIs for the relation of risk factors to leaking urine.

RESULTS: Overall, 34.1% of the women reported leaking urine at least once per month during the previous 12 months; this prevalence was lowest in the black women (21.2%). After potential confounders were controlled, there were strong trends of increasing prevalence of occasional and frequent leaking with increasing age (P trend <.0001). There was also increasing prevalence of leaking urine with increasing parity; for example, compared with nulliparous women, the odds ratio for frequent leaking was 1.72 (95% CI, 1.55-1.90) among those with ≥5 births. Odds ratios that were associated with parity were higher in women aged <60 years than in women aged ≥60 years. Age at first birth of >35 years was associated with a slight elevation in frequent leaking compared with women with age at first birth from 21 to 25 years but was stronger for women with age at first birth of <21 years (OR, 1.27; 95% CI, 1.13-1.42).

CONCLUSION: In these women, leaking urine is common; this condition is most prevalent in white women, in older women, in parous women, and in women with a younger age at first birth.

Section snippets

The Nurses' Health Study cohort

The Nurses' Health Study cohort was identified when 121,701 female, married registered nurses, 30 to 55 years of age who resided in 1 of 11 US states returned a mailed questionnaire in 1976. The women respond to a biennial mailed questionnaire that requests a variety of information on lifestyle factors and major medical diseases. Follow-up remains high; >92% of the original cohort still participates. This study is approved by the institutional review board of Brigham and Women's Hospital.

Identification of cases of leaking urine and control subjects

In

Results

Among the Nurses' Health Study participants, 34.1% of the women reported leaking urine at least once per month during the previous 12 months (Table I); the prevalence of leaking urine appeared lower in the black, Hispanic, and Asian women compared with white women, although this was most marked for the black women (21.2%). Overall, 17.7% of the women said that they leaked at least once per week; again, this prevalence was lowest among the black women (9.6%). Among those women who reported any

Comment

In this cohort of 83,168 female health professionals, aged 50 to 75 years, 34% of the women reported leaking urine at least monthly in the previous year. After adjustment for risk factor differences, the prevalence of frequent leaking of urine was higher in the white women than among other ethnic groups; black women had the lowest prevalence. Among all women, the prevalence of leaking urine increased substantially with increasing age and greater number of births; however, parity appeared to be

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    • Cited by (0)

    ☆

    Supported by grants No. DK62438 and CA40356 from the National Institutes of Health.

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