Natural History of Urinary Incontinence from First Childbirth to 30 Months Postpartum

Abstract Purpose The objectives of this study were to determine the incidence of UI in a large cohort of primiparous women before and during pregnancy and over the course of 30 months postpartum, and to identify risk factors for UI during and after pregnancy. Methods Nulliparous women aged 18 to 35 years with singleton pregnancies were interviewed in their third trimester and asked about urinary incontinence before and during pregnancy (n = 3001). After delivery these women were interviewed at 1, 6, 12, 18, 24 and 30 months postpartum and asked about urinary incontinence occurring in the month prior to each interview. Multivariable logistic regression models identified risk factors for UI during pregnancy and during the follow-up period.Results Overall, 4% reported having urinary incontinence before pregnancy and 36.8% during pregnancy. The strongest predictor of urinary incontinence during pregnancy was urinary incontinence before pregnancy (adjusted OR 13.11, 95% CI 7.43-23.13). Among the women with no subsequent pregnancies, the rate of urinary incontinence increased from 12.5% at 6 months postpartum to 27.4% at 30 months postpartum, 52.1% reported UI at one or more postpartum data collection stages, and the strongest predictors of postpartum UI were UI before pregnancy (adjusted OR 3.95 (95% CI 1.60-9.75) and during pregnancy (adjusted OR 4.36, 95% CI 3.24-5.87). Conclusion Our findings suggest that primiparous women who report UI before and during pregnancy should be monitored for the continuation or worsening of UI over the course of the first 2-3 years postpartum, and treatment options discussed.