Postpartum urinary incontinence

• Published in: Acta obstetricia et gynecologica Scandinavica Vol. 82; no. 6; pp. 556 - 563
• Main Authors: Hvidman, Lone, Foldspang, Anders, Mommsen, SØren, Nielsen, John Bugge
• Format: Journal Article
• Language: English
• Published: Oxford, UK Munksgaard International Publishers 01.06.2003; Taylor & Francis
• Subjects: Adult; Biological and medical sciences; Birth Weight; Breast Feeding; Cesarean Section - adverse effects; Cross-Sectional Studies; Episiotomy - adverse effects; Female; Humans; Incidence; Infant, Newborn; Labor, Obstetric; Medical sciences; Middle Aged; Models, Theoretical; Nephrology. Urinary tract diseases; Obstetric Labor Complications; postpartum; Postpartum Period; Pregnancy; Risk Factors; urinary incontinence; Urinary Incontinence - epidemiology; Urinary Incontinence - etiology; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; Human; risk factors; Urinary system disease; Statistical analysis; Questionnaire; pregnancy; Urinary tract disease; Puerperium; Urinary incontinence; Obstetrical technique; Voiding dysfunction; Randomization; Vaginal route; Cross sectional study; Risk factor; Female; Influence; postpartum; Bladder disease; Delivery
• ISSN: 0001-6349; 1600-0412
• DOI: 10.1034/j.1600-0412.2003.00132.x

Background.  The aim of the present study was to identify prepregnancy, pregnancy and delivery correlates of urinary incontinence postpartum (PP UI) as reported by women in a cross‐sectional population sample. Methods.  A questionnaire‐based cross‐sectional survey was carried out in 1998 in a random population sample of 3900 20‐ to 59‐year‐old women. The present study includes 376 women who had their last delivery during 1993–96. Results.  UI immediately after childbirth and 6 months thereafter was reported by 23.4% and 2.7%, respectively. PP UI was strongly associated with UI both before and during the present pregnancy, explaining 37.5% and 51.7% of postpartum UI, respectively. Eight percent experienced their first UI episode ever immediately after the delivery. Among women undergoing a cesarean section 8.8% reported postpartum UI, as contrasted with 24.9% in other women. Postpartum UI was positively associated with perineal suturing but un‐associated with labor augmentation, episiotomy, birth weight, and breast‐feeding. Conclusion.  In the present study, which included a comprehensive causal model, postpartum UI could be explained first of all as the decline of pregnancy UI, secondly as a manifestation of a pre‐existing tendency to react by UI, and finally as a consequence of the birth process itself.