Urinary incontinence 4 and 12 years after first delivery: Risk factors associated with prevalence, incidence, remission, and persistence in a cohort of 236 women.

Anne-Cécile Pizzoferrato (1, 2) , Arnaud Fauconnier (2, 3) , Emeline Quiboeuf (1, 4) , Karine Morel (4) , Jean-Patrick Schaal (5) , Xavier Fritel (6, 7, 8, 9)

1 UMR_S 953 - Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants
2 Service de gynécologie et obstétrique [CHI Poissy-Saint Germain]
3 RISCQ - Risques cliniques et sécurité en santé des femmes et en santé périnatale
4 UR - Université de La Réunion
5 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
6 Université de Poitiers - Faculté de Médecine et de Pharmacie
7 Service de gynécologie, obstétrique, médecine et biologie de la reproduction [CHU Poitiers] = Department of Gynecology, Obstetrics, Reproductive Medicine and Biology [Poitiers University Hospital]
8 CIC 1402 - CIC Poitiers – Centre d'investigation clinique de Poitiers
9 CESP - Centre de recherche en épidémiologie et santé des populations

AIMS: Our aim was to study risk factors associated with prevalence, incidence, and remission of UI 4 and 12 years after first delivery. METHODS: Seven hundred seventy-four nulliparous women who gave birth in 1996 in two French maternity units at term received a questionnaire about their urinary symptoms in 2000 and again in 2008. Two hundred thirty-six women returned a questionnaire about UI 4 and 12 years after first delivery. Four groups of women were built: (A) women continent 4 and 12 years after first delivery; (B) women continent at 4 and incontinent at 12 years; (C) women incontinent at 4 and continent at 12 years; and (D) women incontinent at 4 and 12 years. Multivariate logistic regressions were used to determine risk factors of UI prevalence (groups B + D vs. A + C), incidence (B vs. A), remission (C vs. D), and onset of UI (D vs. B). RESULTS: Factors associated with UI 12 years after first pregnancy were: BMI (OR = 1.17 [95%CI: 1.04-1.32], by 1 kg/m(2) ) and increasing BMI (1.43 [1.19-1.73]), first child's weight (1.08 [1.001-1.16], by 100 g) and UI during first pregnancy (3.77 [1.83-7.76]). Factors associated with UI incidence were age at first delivery (0.86 [0.75-0.98]) and high BMI (1.24 [1.05-1.45]). Increasing BMI, UI during first pregnancy, and heavy first child reduce the likelihood of UI remission (0.37 [0.20-0.68], 0.11 [0.02-0.63], and 0.73[0.59-0.91], respectively). CONCLUSIONS: UI during first pregnancy could be indicative of individual susceptibility to UI. Obesity appears to be a modifiable factor for remission of UI in women. Neurourol. Urodynam. © 2013 Wiley Periodicals, Inc.

Mots clés: Urinary incontinence; mode of delivery; parity; body mass index; age

Domaines: Gynécologie et obstétrique

Anne-Cécile Pizzoferrato, Arnaud Fauconnier, Emeline Quiboeuf, Karine Morel, Jean-Patrick Schaal, et al.. Urinary incontinence 4 and 12 years after first delivery: Risk factors associated with prevalence, incidence, remission, and persistence in a cohort of 236 women.: Urinary incontinence 4 and 12 years after first delivery. Neurourology and Urodynamics, 2014, 181, pp.259-66. ⟨10.1002/nau.22498⟩. ⟨inserm-00908244⟩