Urinary incontinence persisting after childbirth: extent, delivery history, and effects in a 12-year longitudinal cohort study

C MacArthur, D Wilson, P Herbison, R J Lancashire, S Hagen, P Toozs-Hobson, N Dean, C Glazener, ProLong study group

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Pages (from-to)1022-1029
Number of pages8
JournalBJOG-An International Journal of Obstetrics and Gynaecology
Volume123
Issue number6
Early online date2 Apr 2015
DOIs
Publication statusPublished - May 2016

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Urinary Incontinence
Longitudinal Studies
Cohort Studies
History
Parturition
Cesarean Section
Birth Order
Parity
Obstetrics
Obesity
Odds Ratio
Quality of Life
Pregnancy

Keywords

  • long-term
  • postpartum
  • risk factors
  • urinary incontinence

Cite this

Urinary incontinence persisting after childbirth : extent, delivery history, and effects in a 12-year longitudinal cohort study. / MacArthur, C; Wilson, D; Herbison, P; Lancashire, R J; Hagen, S; Toozs-Hobson, P; Dean, N; Glazener, C; ProLong study group.

In: BJOG-An International Journal of Obstetrics and Gynaecology, Vol. 123, No. 6, 05.2016, p. 1022-1029.

Research output: Contribution to journalArticle

MacArthur, C ; Wilson, D ; Herbison, P ; Lancashire, R J ; Hagen, S ; Toozs-Hobson, P ; Dean, N ; Glazener, C ; ProLong study group. / Urinary incontinence persisting after childbirth : extent, delivery history, and effects in a 12-year longitudinal cohort study. In: BJOG-An International Journal of Obstetrics and Gynaecology. 2016 ; Vol. 123, No. 6. pp. 1022-1029.
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T1 - Urinary incontinence persisting after childbirth

T2 - 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

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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.

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.

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KW - risk factors

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