Prevalence and Associated Factors of Urinary Incontinence among Chinese Adolescents in Henan Province: A Cross-Sectional Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Ethical Considerations
2.3. Sample and Setting
2.4. Instrumentation
2.4.1. Demographic Information
2.4.2. International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF)
2.4.3. Mental Health Inventory of Middle-School Students (MMHI-60)
2.5. Data Analysis
3. Results
3.1. Demographic Information
3.2. Prevalence of UI
3.3. Associated Factors of UI
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Related Factors | Total | Non-UI | UI | p Value | |
---|---|---|---|---|---|
Age (years) | 14–16 | 5881 (39.1) | 5543 (94.3) | 338 (5.7) | 0.001 |
17–20 | 9174 (60.9) | 8517(92.8) | 657 (7.2) | ||
Sex | Boys | 7514 (49.9) | 7060 (94.0) | 454 (6.0) | 0.005 |
Girls | 7541 (50.1) | 7000 (92.8) | 541 (7.2) | ||
BMI | Underweight | 1346 (9.1) | 1257 (93.4) | 89 (6.6) | 0.671 |
Normal weight | 12,294 (82.7) | 11,493 (93.5) | 801 (6.5) | ||
Overweight | 1226 (8.2) | 1138 (92.8) | 88 (7.2) | ||
Ethnicity | Han | 14,679 (97.5) | 13,710 (93.4) | 969 (6.6) | 0.809 |
Minority | 376 (2.5) | 350 (93.1) | 26 (6.9) | ||
Inhabitation | Urban | 5984 (39.7) | 5675 (94.8) | 309 (5.2) | <0.001 |
Rural | 8411 (55.9) | 7788 (92.6) | 623 (7.4) | ||
Rural-urban continuum | 660 (4.4) | 597 (90.5) | 63 (9.5) | ||
Grade | First year | 5279 (35.1) | 4989 (94.5) | 290 (5.5) | <0.001 |
Second year | 4009 (26.6) | 3759 (93.8) | 250 (6.2) | ||
Third year | 5620 (37.3) | 5182 (92.2) | 438 (7.8) | ||
Fourth year | 147 (1.0) | 130 (88.4) | 17 (11.6) | ||
Residence on campus | No | 4047 (26.9) | 3836 (94.8) | 211 (5.2) | <0.001 |
Yes | 11,008 (73.1) | 10,224 (92.9) | 784 (7.1) | ||
Smoking | No | 14,333 (95.2) | 13,420 (93.6) | 913 (6.4) | <0.001 |
Yes | 722 (4.8) | 640 (88.6) | 82 (11.4) | ||
Alcohol consumption | No | 13,091 (87.0) | 12,281 (93.8) | 810 (6.2) | <0.001 |
Yes | 1964 (13.0) | 1779 (90.6) | 185 (9.4) | ||
Sexual behavior | Ever active | 674 (4.5) | 572 (93.8) | 102 (6.2) | <0.001 |
Never active | 14,381 (95.5) | 13,488 (84.9) | 893 (15.1) | ||
Frequency of sexual behavior in the last month | 0 | 14,447 (96.0) | 13,554 (93.8) | 893 (6.2) | <0.001 |
1/w | 339 (2.3) | 299 (88.2) | 40 (11.8) | ||
2–3/w | 65 (0.4) | 59 (90.8) | 6 (9.2) | ||
4–5/w | 41 (0.3) | 32 (78.0) | 9 (22.0) | ||
>5/w | 163 (1.1) | 116 (71.2) | 47 (28.8) | ||
Physical disease | No | 14,086 (93.6) | 13,225 (93.9) | 861 (6.1) | <0.001 |
Yes | 969 (6.4) | 835 (86.2) | 134 (13.8) | ||
Gastropathy | No | 14,894 (98.9) | 13,923 (93.5) | 971 (6.5) | <0.001 |
Yes | 161 (1.1) | 137 (85.1) | 24 (14.9) | ||
Coryza | No | 14,944 (99.3) | 13,955 (93.4) | 989 (6.6) | 0.608 |
Yes | 111 (0.7) | 105 (94.6) | 6 (5.4) | ||
Chronic constipation | No | 13,471 (89.5) | 12,704 (94.3) | 767 (5.7) | <0.001 |
Yes | 1584 (10.5) | 1356 (85.6) | 228 (14.4) | ||
Game addiction | No | 13,982 (92.9) | 13,092 (93.6) | 890 (6.4) | <0.001 |
Yes | 1073 (7.1) | 968 (90.2) | 105 (9.8) | ||
Single parent | No | 14,061 (93.4) | 13,149 (93.5) | 912 (6.5) | 0.022 |
Yes | 994 (6.6) | 911 (91.6) | 83 (8.4) | ||
Father’s education level | High school & below | 10,790 (71.7) | 10,052 (93.2) | 738 (6.8) | <0.001 |
Junior college | 2208 (14.7) | 2077 (94.1) | 131 (5.9) | ||
Bachelor | 1700 (11.3) | 1616 (95.1) | 84 (4.9) | ||
Master | 140 (0.9) | 130 (92.9) | 10 (7.1) | ||
PhD | 217 (1.4) | 185 (85.3) | 32 (14.7) | ||
Mother’s education level | High school & below | 11,436 (76.0) | 10,668 (93.3) | 768 (6.7) | <0.001 |
Junior college | 1748 (11.6) | 1634 (93.5) | 114 (6.5) | ||
Bachelor | 1569 (10.4) | 1497 (95.4) | 72 (4.6) | ||
Master | 101 (0.7) | 89 (88.1) | 12 (11.9) | ||
PhD | 201 (1.3) | 172 (85.6) | 29 (14.4) | ||
MMHI-60 | Normal | 8768 (58.2) | 8387 (95.7) | 381 (4.3) | <0.001 |
Mild | 5538 (36.8) | 5049 (91.2) | 489 (8.8) | ||
Moderate | 702 (4.7) | 592 (84.3) | 110 (15.7) | ||
Serious and very serious | 47 (0.3) | 32 (68.1) | 15 (31.9) |
Age (Years) | Boys | Girls | Total | p Value * | ||||||
---|---|---|---|---|---|---|---|---|---|---|
N (%) | UI | Rate (95%CI), % | N (%) | UI | Rate (95%CI), % | N (%) | UI | Rate (95%CI), % | ||
14–15 | 473 (6.3) | 28 | 5.9 (3.7, 8.1) | 538 (7.1) | 31 | 5.8 (3.8, 7.8) | 1011 (6.7) | 59 | 5.8 (4.4, 7.2) | 0.915 |
16 | 2293 (30.5) | 130 | 5.7 (4.7, 6.7) | 2577 (34.2) | 149 | 5.8 (4.8, 6.8) | 4870 (32.4) | 279 | 5.7 (5.1, 6.3) | 0.866 |
17 | 3294 (43.8) | 181 | 5.5 (4.7, 6.3) | 3288 (43.6) | 258 | 7.8 (6.8, 8.8) | 6582 (43.7) | 439 | 6.7 (6.1, 7.3) | <0.001 |
18 | 1312 (17.5) | 98 | 7.5 (6.1, 8.9) | 1037 (13.8) | 90 | 8.7 (6.9, 10.5) | 2349 (15.6) | 188 | 8.0 (6.8, 9.2) | 0.283 |
19–20 | 142 (1.9) | 17 | 12.0 (6.7, 17.3) | 101 (1.3) | 13 | 12.9 (6.4, 19.4) | 243 (1.6) | 30 | 12.3 (8.2,16.4) | 0.834 |
Total | 7514 | 454 | 6.0 (5.4, 6.6) # | 7541 | 541 | 7.2 (6.6, 7.8) § | 15,055 | 995 | 6.6 (6.2, 7.0) | 0.005 |
Characteristics | N (%) | |
---|---|---|
Frequency of urinary leakage | Never | 14,060 (93.4) |
Approximately once per week or less often | 733 (4.9) | |
Two or three times per week | 108 (0.7) | |
Approximately once per day | 50 (0.3) | |
Several times per day | 40 (0.3) | |
All the time | 64 (0.4) | |
Amount of usual leakage | A small amount | 867 (87.1) |
A moderate amount | 58 (5.8) | |
A large amount | 70 (7.1) | |
Impact of UI on daily life | Mild | 795 (79.9) |
Moderate | 93 (9.3) | |
Severe | 20 (2.0) | |
Very severe | 87 (8.8) | |
The situation or causes leading to UI | Never—urine does not leak | 14,060 (93.4) |
Leaks before you can get to the toilet | 273 (1.8) | |
Leaks when you cough or sneeze | 225 (1.5) | |
Leaks when you are asleep | 333 (2.2) | |
Leaks when you are physically active/exercising | 153 (1.0) | |
Leaks when you have finished urinating and are dressed | 220 (1.5) | |
Leaks for no obvious reason | 211 (1.4) | |
Leaks all the time | 83 (0.6) |
Related Factors | UI OR (95%CI) | Stress UI OR (95%CI) | Urgency UI OR (95%CI) | Mixed UI OR (95%CI) | NE OR (95%CI) | |
---|---|---|---|---|---|---|
Age (years) | 14–16 (ref.) | |||||
17–20 | 1.27 (1.10–1.45) | 1.63 (1.24–2.15) | 1.26 (1.07–1.49) | 0.56 (0.36–0.88) | 1.25 (1.00–1.58) | |
Sex | Boys (ref.) | |||||
Girls | 1.20 (1.06–1.37) | 3.59 (2.66–4.84) | 0.87 (0.74–1.01) | 0.97 (0.62–1.51) | 0.78 (0.63–0.97) | |
BMI | Underweight (ref.) | |||||
Normal weight | 0.98 (0.78–1.23) | 1.66 (0.96–2.86) | 0.98 (0.74–1.29) | 0.92 (0.44–1.91) | 0.88 (0.61–1.26) | |
Overweight | 1.09 (0.80–1.48) | 2.06 (1.07–3.97) | 1.12 (0.78–1.62) | 0.55 (0.16–1.82) | 0.64 (0.37–1.12) | |
Ethnicity | Han (ref.) | |||||
Minority | 1.05 (0.70–1.57) | 0.31 (0.08–1.23) | 1.44 (0.94–2.21) | 0.00 (0.00-Inf) | 1.74 (1.01–3.00) | |
Inhabitation | Urban (ref.) | |||||
Rural | 1.47 (1.28–1.69) | 1.47 (1.12–1.92) | 1.46 (1.23–1.73) | 1.00 (0.62–1.59) | 1.68 (1.31–2.15) | |
Rural-urban continuum | 1.94 (1.46–2.57) | 1.50 (0.83–2.72) | 1.87 (1.32–2.64) | 2.13 (0.93–4.86) | 2.63 (1.69–4.09) | |
Grade | First year (ref.) | |||||
Second year | 1.14 (0.96–1.36) | 1.14 (0.80–1.63) | 1.09 (0.88–1.34) | 1.52 (0.90–2.58) | 1.27 (0.94–1.70) | |
Third year | 1.45 (1.25–1.70) | 1.78 (1.32–2.41) | 1.39 (1.15–1.67) | 0.83 (0.47–1.46) | 1.48 (1.14–1.92) | |
Fourth year | 2.25 (1.34–3.78) | 1.62 (0.50–5.21) | 2.72 (1.54–4.80) | 0.00 (0.00–Inf) | 2.37 (1.02–5.51) | |
Residence on campus | No (ref.) | |||||
Yes | 1.39 (1.19–1.63) | 1.44 (1.06–1.95) | 1.40 (1.15–1.69) | 1.02 (0.62–1.68) | 1.39 (1.07–1.81) | |
Smoking | No (ref.) | |||||
Yes | 1.88 (1.48–2.39) | 0.48 (0.21–1.07) | 2.20 (1.68–2.88) | 3.60 (1.94–6.68) | 3.33 (2.42–4.59) | |
Alcohol consumption | No (ref.) | |||||
Yes | 1.58 (1.33–1.86) | 0.72 (0.48–1.10) | 1.86 (1.53–2.25) | 2.12 (1.26–3.56) | 2.30 (1.79–2.96) | |
Sexual behavior | Never active (ref.) | |||||
Ever active | 2.69 (2.16–3.36) | 1.25 (0.73–2.15) | 3.05 (2.37–3.92) | 2.42 (1.16–5.05) | 4.19 (3.09–5.70) | |
Frequency of sexual behavior in the last month | 0 (ref.) | |||||
1/w | 2.03 (1.45–2.84) | 1.24 (0.58–2.66) | 2.32 (1.58–3.41) | 1.81 (0.57–5.77) | 2.17 (1.26–3.76) | |
2–3/w | 1.54 (0.66–3.58) | 0.92 (0.13–6.67) | 1.57 (0.57–4.33) | 0.00 (0.00–Inf) | 2.44 (0.76–7.82) | |
4–5/w | 4.34 (1.42–13.20) | 5.61 (1.31–24.08) | 4.78 (1.38–16.56) | 11.91 (1.56–90.71) | 14.40 (4.71–44.03) | |
>5/w | 6.15 (4.35–8.69) | 1.11 (0.35–3.49) | 7.78 (5.39–11.21) | 5.09 (1.84–14.12) | 10.91 (7.18–16.58) | |
Physical disease | No (ref.) | |||||
Yes | 2.46 (2.03–3.00) | 1.82 (1.23–2.72) | 2.43 (1.92–3.06) | 3.16 (1.77–5.65) | 2.46 (1.79–3.37) | |
Gastropathy | No (ref.) | |||||
Yes | 2.51 (1.62–3.89) | 1.49 (0.55–4.06) | 2.44 (1.45–4.12) | 3.70 (1.16–11.86) | 2.34 (1.14–4.81) | |
Coryza | No (ref.) | |||||
Yes | 0.81 (0.35–1.84) | 1.07 (0.26–4.36) | 0.81 (0.30–2.22) | 1.73 (0.24–12.57) | 0.40 (0.06–2.87) | |
Chronic constipation | No (ref.) | |||||
Yes | 2.78 (2.38–3.26) | 1.65 (1.18–2.32) | 2.86 (2.37–3.45) | 5.01 (3.16–7.93) | 2.97 (2.31–3.83) | |
Game addiction | No (ref.) | |||||
Yes | 1.60 (1.29–1.97) | 0.76 (0.44–1.30) | 1.89 (1.48–2.41) | 1.90 (0.97–3.69) | 2.14 (1.56–2.94) | |
Single parent | No (ref.) | |||||
Yes | 1.31 (1.04–1.66) | 1.15 (0.72–1.84) | 1.39 (1.05–1.83) | 0.96 (0.39–2.37) | 1.80 (1.27–2.55) | |
Father’s education level | Bachelor (ref.) | |||||
High school & below | 1.41 (1.12–1.78) | 1.89 (1.15–3.11) | 1.39 (1.05–1.84) | 0.79 (0.40–1.55) | 1.21 (0.83–1.78) | |
Junior college | 1.21 (0.92–1.61) | 1.36 (0.75–2.48) | 1.15 (0.81–1.62) | 1.23 (0.56–2.73) | 1.21 (0.76–1.92) | |
Master | 1.48 (0.75–2.92) | 2.17 (0.63–7.49) | 1.55 (0.69–3.46) | 0.00 (0.00-Inf) | 0.81 (0.19–3.41) | |
PhD | 3.33 (2.15–5.14) | 0.92 (0.21–4.01) | 4.17 (2.57–6.76) | 2.37 (0.65–8.68) | 6.92 (3.97–12.08) | |
Mother’s education level | Bachelor (ref.) | |||||
High school & below | 1.50 (1.17–1.92) | 1.54 (0.96–2.47) | 1.51 (1.11–2.05) | 0.94 (0.45–1.98) | 1.35 (0.89–2.05) | |
Junior college | 1.45 (1.07–1.96) | 0.94 (0.50–1.78) | 1.61 (1.11–2.33) | 1.46 (0.60–3.54) | 1.26 (0.75–2.12) | |
Master | 2.80 (1.47–5.36) | 0.82 (0.11–6.16) | 3.24 (1.54–6.82) | 1.95 (0.24–15.76) | 3.90 (1.56–9.74) | |
PhD | 3.51 (2.22–5.55) | 0.82 (0.19–3.55) | 4.70 (2.82–7.84) | 1.96 (0.41–9.30) | 7.59 (4.19–13.74) | |
MMHI-60 | Normal (ref.) | |||||
Mild | 2.13 (1.86–2.45) | 1.51 (1.17–1.96) | 2.18 (1.84–2.58) | 4.43 (2.58–7.60) | 2.12 (1.67–2.70) | |
Moderate | 4.09 (3.26–5.14) | 2.11 (1.31–3.41) | 4.49 (3.45–5.86) | 5.60 (2.43–12.93) | 4.74 (3.32–6.78) | |
Serious and very serious | 10.32 (5.54–19.22) | 0.00 (0.00-Inf) | 10.67 (5.37–21.22) | 33.14 (9.42–116.57) | 30.83 (16.08–59.11) |
Related Factors | UI OR (95%CI) | Stress UI OR (95%CI) | Urgency UI OR (95%CI) | Mixed UI OR (95%CI) | NE OR (95%CI) | |
---|---|---|---|---|---|---|
Age (years) | 14–16 (ref.) | |||||
17–20 | - | - | - | 0.48 (0.29–0.80) | - | |
Sex | Boys (ref.) | |||||
Girls | 1.27 (1.11–1.45) | 3.66 (2.70–4.95) | - | - | - | |
Inhabitation | Urban (ref.) | |||||
Rural | 1.37 (1.17–1.60) | 1.21 (0.90–1.62) | 1.43 (1.20–1.70) | - | 1.74 (1.33–2.28) | |
Rural-urban continuum | 1.45 (1.08–1.95) | 1.28 (0.70–2.33) | 1.37 (0.95–1.96) | - | 1.89 (1.19–3.02) | |
Grade | First year (ref.) | |||||
Second year | 1.18 (0.98–1.40) | 1.17 (0.82–1.67) | 1.12 (0.90–1.39) | 1.95 (1.12–3.38) | 1.36 (1.01–1.84) | |
Third year | 1.36 (1.16–1.59) | 1.66 (1.23–2.25) | 1.29 (1.06–1.56) | 1.08 (0.57–2.07) | 1.39 (1.06–1.82) | |
Fourth year | 1.51 (0.87–2.65) | 1.57 (0.48–5.13) | 1.86 (1.02–3.41) | 0.00 (0.00–Inf) | 1.05 (0.39–2.78) | |
Smoking | No (ref.) | |||||
Yes | - | - | - | 2.24 (1.15–4.35) | - | |
Alcohol consumption | No (ref.) | |||||
Yes | - | - | 1.27 (1.03–1.57) | - | 1.43 (1.08–1.89) | |
Frequency of sexual behavior in the last month | 0 (ref.) | |||||
1/w | 1.82 (1.28–2.59) | 1.52 (0.70–3.28) | 1.86 (1.25–2.78) | - | 1.52 (0.85–2.72) | |
2–3/w | 2.96 (1.03–8.54) | 1.45 (0.20–10.71) | 1.19 (0.42–3.34) | - | 1.85 (0.57–6.04) | |
4–5/w | 2.07 (0.58–7.41) | 7.71 (1.65–35.90) | 2.36 (0.67–8.27) | - | 4.54 (1.08–19.03) | |
>5/w | 4.48 (3.07–6.54) | 1.54 (0.47–5.02) | 5.16 (3.48–7.66) | - | 5.73 (3.54–9.29) | |
Physical disease | No (ref.) | |||||
Yes | 1.73 (1.40–2.13) | 1.61 (1.06–2.44) | 1.59 (1.24–2.04) | 1.86 (1.00–3.44) | 1.44 (1.02–2.05) | |
Chronic constipation | No (ref.) | |||||
Yes | 2.03 (1.72–2.40) | 1.30 (0.92–1.85) | 2.06 (1.69–2.51) | 3.64 (2.25–5.90) | 1.93 (1.47–2.55) | |
Father’s education level | Bachelor (ref.) | |||||
High school & below | 1.28 (1.00–1.64) | 1.76 (1.05–2.96) | - | - | 0.98 (0.65–1.48) | |
Junior college | 1.26 (0.94–1.68) | 1.41 (0.77–2.58) | - | - | 1.20 (0.75–1.93) | |
Master | 1.39 (0.69–2.81) | 2.43 (0.69–8.56) | - | - | 0.69 (0.16–2.96) | |
PhD | 2.02 (1.24–3.29) | 0.95 (0.21–4.32) | - | - | 2.97 (1.56–5.62) | |
MMHI-60 | Normal (ref.) | |||||
Mild | 1.88 (1.63–2.16) | 1.43 (1.10–1.86) | 1.88 (1.58–2.23) | 3.69 (2.14–6.38) | 1.80 (1.41–2.30) | |
Moderate | 2.87 (2.25–3.65) | 1.82 (1.10–3.00) | 3.01 (2.27–3.98) | 3.55 (1.49–8.45) | 2.94 (2.00–4.32) | |
Serious and very serious | 4.57 (2.27–9.27) | 0.00 (0.00-Inf) | 4.40 (2.03–9.53) | 12.79 (3.23–50.61) | 11.57 (5.35–25.03) |
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Luo, Y.; Zou, P.; Wang, K.; Cui, Z.; Li, X.; Wang, J. Prevalence and Associated Factors of Urinary Incontinence among Chinese Adolescents in Henan Province: A Cross-Sectional Survey. Int. J. Environ. Res. Public Health 2020, 17, 6106. https://doi.org/10.3390/ijerph17176106
Luo Y, Zou P, Wang K, Cui Z, Li X, Wang J. Prevalence and Associated Factors of Urinary Incontinence among Chinese Adolescents in Henan Province: A Cross-Sectional Survey. International Journal of Environmental Research and Public Health. 2020; 17(17):6106. https://doi.org/10.3390/ijerph17176106
Chicago/Turabian StyleLuo, Yan, Ping Zou, Kai Wang, Zhenti Cui, Xiaomei Li, and Jing Wang. 2020. "Prevalence and Associated Factors of Urinary Incontinence among Chinese Adolescents in Henan Province: A Cross-Sectional Survey" International Journal of Environmental Research and Public Health 17, no. 17: 6106. https://doi.org/10.3390/ijerph17176106