Urinary Incontinence Common Before, During Pregnancy

More than one third of nulliparous women leak urine before and during pregnancy, and most ignore symptoms, investigators in Ireland reported.

In a prospective cohort study of 860 nulliparous women recruited during pregnancy, Deirdre Daly, PhD, of Trinity College Dublin, and colleagues found that the prevalence of any urinary leakage was 34.8% and 38.7% before and during pregnancy, respectively, according to a report published online ahead of print in the International Gynecology Journal. The prevalence of urinary incontinence (UI)—leaking urine at least once per month—was 7.2% and 17.7%, respectively.

Before and during pregnancy, 59.7% and 58.8% of women reported mixed UI, respectively, 22.6% and 37.2% reported stress UI (SUI), and 17.7% and 4.0% reported urge UI (UUI). In adjusted analyses, pre-pregnancy UI was significantly associated with nearly 3-fold greater odds of childhood enuresis and 4.2-fold greater odds of obesity (body mass index [BMI] 30 kg/m² or higher).

New-onset UI during pregnancy was more likely to be reported by women aged 35 years or older compared with those aged 25 to 29 years, women who were overweight (BMI 25 to 29.99 kg/m²) versus normal weight (BMI 18.5 to 24.99 kg/m²) before pregnancy, and women who leaked urine less than once per month versus those who leaked urine more frequently.

“For the first time [in Ireland], findings from our study provide information on continence status pre- and during pregnancy, and these are directly relevant to clinical practice,” Dr Daly and her colleagues wrote. “In Ireland—and many other countries—women booking for antenatal care are not asked directly about their experience of leaking urine.”

In the study, almost all symptomatic women reported symptoms of slight to moderate severity before and during pregnancy, according to Dr Daly and her team. The study revealed that 55% of symptomatic women ignored leaking urine during pregnancy.

“The finding that most women ignore symptoms is worrying and raises questions for healthcare professionals about finding ways of addressing UI, which is preventable and/or curable,” the authors wrote. “Healthcare professionals have several opportunities to promote urinary continence in all women during their regular antenatal appointments, particularly in those with identifiable risk factors, by offering advice on and reminders to preform pelvic floor muscle training.”

Daly D, Clarke M, Begley C. Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, type, and risk factors. Int Urogynecol J 2018 Jan 23 doi: 1007/s00192-018-3554-1

https://www.ncbi.nlm.nih.gov/pubmed/29362836