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Erschienen in: International Urogynecology Journal 5/2012

01.05.2012 | Original Article

Prevalence and risk factors for peri- and postpartum urinary incontinence in primiparous women in China: a prospective longitudinal study

verfasst von: Lan Zhu, L. Li, Jing-he Lang, T. Xu

Erschienen in: International Urogynecology Journal | Ausgabe 5/2012

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Abstract

Introduction and hypothesis

We sought to characterize risk factors of urinary incontinence (UI) during pregnancy and the postpartum period in primiparous women in China.

Methods

We enrolled 10,098 women from the seven regions of China ≥28 weeks’ gestation from September 2007 to May 2009 and administered the Bristol Female Lower Urinary Tract Symptoms questionnaire to estimate the presence of different types of UI during late pregnancy (37 to 42 weeks’ gestation) and at 6 weeks and 6 months postpartum. We also collected details of pregnancy and childbirth and demographic data. McNemar’s test, multinomial logistic regression models, and binary logistic regression models were used.

Results

Multivariable analysis revealed six independent risk factors for SUI: age, more frequent exercise, alcohol consumption, higher body mass index, larger waist circumference, and history of constipation. For those with no UI in late pregnancy, 3.7% and 3.0% developed new cases at 6 weeks and 6 months postpartum, respectively. Risk factors for UI at 6 months were frequent exercise, rural residence, perineal laceration, and lateral episiotomy. Prevalence of all UI was 26.7% in late pregnancy, 9.5% at 6 weeks postpartum, and 6.8% at 6 months postpartum. Most cases were stress urinary incontinence (18.6%, 6.9%, and 5.0%, at the respectively times).

Conclusions

Rates of UI in primiparous women in China are consistent with those reported elsewhere. Rural location, frequent exercise, and birth-related injuries are risk factors for UI at 6 months postpartum.
Literatur
2.
Zurück zum Zitat Zhu L, Lang J, Liu C, Han S, Huang J, Li X (2009) The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China. Menopause 16:831–6PubMedCrossRef Zhu L, Lang J, Liu C, Han S, Huang J, Li X (2009) The epidemiological study of women with urinary incontinence and risk factors for stress urinary incontinence in China. Menopause 16:831–6PubMedCrossRef
3.
Zurück zum Zitat Vecchioli-Scaldazza C, Morosetti C (2010) Effect of aging on urinary incontinence in woman. Arch Ital Urol Androl 82:167–71PubMed Vecchioli-Scaldazza C, Morosetti C (2010) Effect of aging on urinary incontinence in woman. Arch Ital Urol Androl 82:167–71PubMed
4.
Zurück zum Zitat Borello-France D, Burgio KL, Richter HE et al (2006) Fecal and urinary incontinence in primiparous women. Obstet Gynecol 108:863–72PubMedCrossRef Borello-France D, Burgio KL, Richter HE et al (2006) Fecal and urinary incontinence in primiparous women. Obstet Gynecol 108:863–72PubMedCrossRef
5.
Zurück zum Zitat Boyles SH, Li H, Mori T, Osterweil P, Guise J (2009) Effect of mode of delivery on the incidence of urinary incontinence in primiparous women. Obstet Gynecol 113:134–41PubMed Boyles SH, Li H, Mori T, Osterweil P, Guise J (2009) Effect of mode of delivery on the incidence of urinary incontinence in primiparous women. Obstet Gynecol 113:134–41PubMed
6.
Zurück zum Zitat Thomason AD, Miller JM, DeLancey JO (2007) Urinary incontinence symptoms during and after pregnancy in continent and incontinent primiparas. Int Urogynecol J Pelvic Floor Dysfunct 18:147–51PubMed Thomason AD, Miller JM, DeLancey JO (2007) Urinary incontinence symptoms during and after pregnancy in continent and incontinent primiparas. Int Urogynecol J Pelvic Floor Dysfunct 18:147–51PubMed
7.
Zurück zum Zitat Glazener CM, Herbison GP, MacArthur C et al (2006) New postnatal urinary incontinence: obstetric and other risk factors in primiparae. BJOG 113:208–17PubMedCrossRef Glazener CM, Herbison GP, MacArthur C et al (2006) New postnatal urinary incontinence: obstetric and other risk factors in primiparae. BJOG 113:208–17PubMedCrossRef
8.
Zurück zum Zitat Eftekhar T, Hajibaratali B, Ramezanzadeh F, Shariat M (2006) Postpartum evaluation of stress urinary incontinence among primiparas. Int J Gynecol Obstet 94:114–8CrossRef Eftekhar T, Hajibaratali B, Ramezanzadeh F, Shariat M (2006) Postpartum evaluation of stress urinary incontinence among primiparas. Int J Gynecol Obstet 94:114–8CrossRef
9.
Zurück zum Zitat Thom DH, Rortveit G (2010) Prevalence of postpartum urinary incontinence: a systematic review. Acta Obstatricia et Gynecologica 89:1511–22CrossRef Thom DH, Rortveit G (2010) Prevalence of postpartum urinary incontinence: a systematic review. Acta Obstatricia et Gynecologica 89:1511–22CrossRef
10.
Zurück zum Zitat Diez-Itza I, Arrue M, Ibañez L, Murgiondo A, Paredes J, Sarasqueta C (2010) Factors involved in stress urinary incontinence 1 year after first delivery. Int Urogynecol J 21:439–45PubMedCrossRef Diez-Itza I, Arrue M, Ibañez L, Murgiondo A, Paredes J, Sarasqueta C (2010) Factors involved in stress urinary incontinence 1 year after first delivery. Int Urogynecol J 21:439–45PubMedCrossRef
11.
Zurück zum Zitat Foldspang A, Mommsen S, Djurhuus JC (1999) Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth, and obstetric techniques. Am J Public Health 89:209–12PubMedCrossRef Foldspang A, Mommsen S, Djurhuus JC (1999) Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth, and obstetric techniques. Am J Public Health 89:209–12PubMedCrossRef
12.
Zurück zum Zitat Viktrup L, Lose G (2008) Incidence and remission of lower urinary tract symptoms during 12 years after the first delivery: a cohort study. J Urol 180:992–7PubMedCrossRef Viktrup L, Lose G (2008) Incidence and remission of lower urinary tract symptoms during 12 years after the first delivery: a cohort study. J Urol 180:992–7PubMedCrossRef
13.
Zurück zum Zitat van Brummen HJ, Bruinse HW, van de Pol G, Heintz PM, van der Vaart CH (2006) Bothersome lower urinary tract symptoms 1 year after first delivery: prevalence and the effect of childbirth. BJU Int 98:89–95PubMedCrossRef van Brummen HJ, Bruinse HW, van de Pol G, Heintz PM, van der Vaart CH (2006) Bothersome lower urinary tract symptoms 1 year after first delivery: prevalence and the effect of childbirth. BJU Int 98:89–95PubMedCrossRef
14.
Zurück zum Zitat Yang X, Zhang HX, Yu HY, Gao XL, Yang HX, Dong Y (2010) The prevalence of fecal incontinence and urinary incontinence in primiparous postpartum Chinese women. Eur J Obstet Gynecol Reprod Biol 152:214–7PubMedCrossRef Yang X, Zhang HX, Yu HY, Gao XL, Yang HX, Dong Y (2010) The prevalence of fecal incontinence and urinary incontinence in primiparous postpartum Chinese women. Eur J Obstet Gynecol Reprod Biol 152:214–7PubMedCrossRef
15.
Zurück zum Zitat Zhu L, Li L, Lang J, Xu T, Wong F (2010) Epidemiology of mixed urinary incontinence in China. Int J Gynaecol Obstet 109:55–8PubMedCrossRef Zhu L, Li L, Lang J, Xu T, Wong F (2010) Epidemiology of mixed urinary incontinence in China. Int J Gynaecol Obstet 109:55–8PubMedCrossRef
16.
Zurück zum Zitat Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P (1996) The Bristol Female Lower Urinary Tract Symptoms questionnaire: development and psychometric testing. Br J Urol 77:805–12PubMedCrossRef Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P (1996) The Bristol Female Lower Urinary Tract Symptoms questionnaire: development and psychometric testing. Br J Urol 77:805–12PubMedCrossRef
17.
Zurück zum Zitat Abrams P, Cardozo L, Fall M et al (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–78PubMedCrossRef Abrams P, Cardozo L, Fall M et al (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–78PubMedCrossRef
18.
Zurück zum Zitat Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Müller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut. 199;45 Suppl 2:II43-7. Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Müller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut. 199;45 Suppl 2:II43-7.
19.
Zurück zum Zitat Dietz HP, Bennett MJ (2003) The effect of childbirth on pelvic organ mobility. Obstet Gynecol 102:223–8PubMedCrossRef Dietz HP, Bennett MJ (2003) The effect of childbirth on pelvic organ mobility. Obstet Gynecol 102:223–8PubMedCrossRef
20.
Zurück zum Zitat Wesnes SL, Rortveit G, Bø K, Hunskaar S (2007) Urinary incontinence during pregnancy. Obstet Gynecol 109:922–8PubMedCrossRef Wesnes SL, Rortveit G, Bø K, Hunskaar S (2007) Urinary incontinence during pregnancy. Obstet Gynecol 109:922–8PubMedCrossRef
21.
Zurück zum Zitat Eason E, Labrecque M, Marcoux S, Mondor M (2004) Effects of carrying a pregnancy and of method of delivery on urinary incontinence: a prospective cohort study. BMC Pregnancy Childbirth 4:4PubMedCrossRef Eason E, Labrecque M, Marcoux S, Mondor M (2004) Effects of carrying a pregnancy and of method of delivery on urinary incontinence: a prospective cohort study. BMC Pregnancy Childbirth 4:4PubMedCrossRef
22.
Zurück zum Zitat Sultan AH, Kamm MA, Hudson CN (1994) Pudendal nerve damage during labour: prospective study before and after childbirth. Br J Obstet Gynaecol 101:22–8PubMedCrossRef Sultan AH, Kamm MA, Hudson CN (1994) Pudendal nerve damage during labour: prospective study before and after childbirth. Br J Obstet Gynaecol 101:22–8PubMedCrossRef
23.
Zurück zum Zitat Long Q, Zhang T, Hemminki E et al (2010) Utilisation, contents and costs of prenatal care under a rural health insurance (New Co-operative Medical System) in rural China: lessons from implementation. BMC Health Serv Res 10:301PubMedCrossRef Long Q, Zhang T, Hemminki E et al (2010) Utilisation, contents and costs of prenatal care under a rural health insurance (New Co-operative Medical System) in rural China: lessons from implementation. BMC Health Serv Res 10:301PubMedCrossRef
24.
Zurück zum Zitat Nwaru BI, Wu Z, Hemminki E (2011) Determinants of the use of prenatal care in rural China: the role of care content. Matern Child Health J. doi:10.1007/s10995-010-0734-0, 2010 Dec 25 Nwaru BI, Wu Z, Hemminki E (2011) Determinants of the use of prenatal care in rural China: the role of care content. Matern Child Health J. doi:10.​1007/​s10995-010-0734-0, 2010 Dec 25
25.
Zurück zum Zitat Chiarelli P, Cockburn J (2002) Promoting urinary continence in women after delivery: randomised controlled trial. BMJ 324:1241PubMedCrossRef Chiarelli P, Cockburn J (2002) Promoting urinary continence in women after delivery: randomised controlled trial. BMJ 324:1241PubMedCrossRef
Metadaten
Titel
Prevalence and risk factors for peri- and postpartum urinary incontinence in primiparous women in China: a prospective longitudinal study
verfasst von
Lan Zhu
L. Li
Jing-he Lang
T. Xu
Publikationsdatum
01.05.2012
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 5/2012
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-011-1640-8

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