Risk of Stress Urinary Incontinence Twelve Years After the First Pregnancy and Delivery

Abstract

OBJECTIVE: 

To estimate the impact of onset of stress urinary incontinence in first pregnancy or postpartum period, for the risk of symptoms 12 years after the first delivery.

METHODS: 

In a longitudinal cohort study, 241 women answered validated questions about stress urinary incontinence after first delivery and 12 years later.

RESULTS: 

Twelve years after first delivery the prevalence of stress urinary incontinence was 42% (102 of 241). The 12-year incidence was 30% (44 of 146). The prevalence of stress urinary incontinence 12 years after first pregnancy and delivery was significantly higher (P<.01) in women with onset during first pregnancy (56%, 37 of 66) and in women with onset shortly after delivery (78%, 14 of 18) compared with those without initial symptoms (30%, 44 of 146). In 70 women who had onset of symptoms during first pregnancy or shortly after the delivery but remission 3 months postpartum, a total of 40 (57%) had stress urinary incontinence 12 years later. In 11 women with onset of symptoms during the first pregnancy or shortly after delivery but no remission 3 months postpartum, a total of 10 (91%) had stress urinary incontinence 12 years later. Cesarean during first delivery was significantly associated with a lower risk of incontinence. Other obstetric factors were not significantly associated with the risk of incontinence 12 years later. Patients who were overweight before their first pregnancy were at increased risk.

CONCLUSION: 

Onset of stress urinary incontinence during first pregnancy or puerperal period carries an increased risk of long-lasting symptoms.

LEVEL OF EVIDENCE: 

II-2

In Brief

Onset of stress urinary incontinence during first pregnancy or first puerperal period is associated with a high risk of symptoms 12 years later.