Incontinence In Pregnancy Research Articles

Urinary Incontinence in Pregnancy and Its Effect on Quality of Life

Objective: The aim of the study is to determine the incidence of urinary incontinence during pregnancy, its impact on quality of life, and the affecting factors. Methods: The descriptive study was conducted on 300 pregnant women who applied to the pregnant outpatient clinic of a hospital in Ordu between December 2017 and May 2018. Data were collected using the Personal Information Form, Incontinence Quality of Life Scale (ASQI), and Incontinence Severity Index (ISI). Results: It was determined that 91.7% of the pregnant women did not have urinary incontinence before pregnancy and 49.3% of them had urinary incontinence during pregnancy. It was found that 82.4% experienced incontinence during coughing and 75% during sneezing. It was determined that 35.7% of the pregnant women with urinary incontinence had mixed type UI, 31.6% had stress UI and 4.1% had urge UI. When the Incontinence Severity Index score of the pregnant women with urinary incontinence was evaluated, it was found that 54.7% were mild, 43.2% were moderate and 2% were in the severe group. There was a statistically significant difference between UI and the number of years, week, BMI, and type of delivery (p <0.05). There was a statistically significant difference between the gestational weeks of the patients with urinary incontinence in terms of quality of life and limitation of behavior subscale scores (p<0.05). Conclusions: Incontinence quality of life levels of pregnant women with urinary incontinence were found to be lower than pregnant women without urinary incontinence.

Prevalence and incidence of urinary incontinence in pregnancy: a review

The uncontrolled flow of urine that happens when someone sneezes, coughs, or engages in physical activity is known as urinary incontinence (UI). The most common kind of urine incontinence that affects women is this one. Hence, this study aimed to examine the incidence, prevalence, and contributing factors of pregnancy-related UI. An electronic literature search was conducted in the MEDLINE database using the search phrases "Urinary Incontinence," "UI," "Pregnancy," "Prevalence," and "Risk Factors" to discover relevant papers between 2018 and 2024. On Google Scholar, relevant search terms were employed to search for academic publications. Several inclusion criteria served as a guide for the selection of articles. It was found that UI is a condition that often increases in prevalence from 6 months to 12 years postpartum. Typically, it is of low to moderate severity and has little impact on the overall well-being of the majority of persons. Furthermore, the study highlighted the importance of pregnancy, rather than the act of giving birth, in the subsequent development of urine incontinence in the long term after delivery. Women who gave birth vaginally had a greater occurrence of persistent UI as compared to those who had cesarean deliveries. During pregnancy, more than 50% of women suffer from urine incontinence. Nevertheless, the majority saw a rapid recovery during the first year after childbirth.

Urinary Incontinence in Pregnancy and after Childbirth

Introduction: The development of incontinence depends on many factors and more often affects women who have already given birth. It is related to the growth of the fetus and the pressure of the head and fetus on the bladder and pelvic floor muscles. Hormonal influences also play an important role, as they relax the muscles and also affect the pelvic ligament. Due to this fact, in the research, we investigated urinary incontinence in a selected research sample and determined the degree of connection between incontinence of the respondents and factors such as pregnancy, number of births and the method of delivery. Methods: Using Microsoft Excel, we performed a mathematical-statistical evaluation of the data, which we expressed as a percentage in the attached graphic and tabular processing. We verified the hypotheses with the correlation coefficient, the Spearman coefficient and the non-parametric Kruskal-Wallis test. We made the decision about the existence of statistical significance based on the calculated p value and the significance level of 0.05. Results: By processing the results, we pointed out the degree of connection of urinary incontinence with several factors, namely pregnancy, the method of delivery and the number of births. For stress and overflow incontinence, the differences between the groups are very small. In urge incontinence, the differences are more pronounced between means and the mean ranks. However, even here, significant difference between the groups was not confirmed. Also, the connection between the number of births and urinary incontinence was not confirmed. However, we found a connection between the method of delivery and overflow and urge incontinence. Conclusion: Urinary incontinence during pregnancy and after childbirth is a significant burden for a woman. It covers the issues of the women it concerns in all spheres of life. Urinary incontinence is a certain burden for the whole society, not only for the affected woman. Therefore, one cannot forget exact drug therapy and other conservative treatment procedures, including the often underappreciated special therapeutic gymnastics – pelvic floor strengthening.

Urinary and anal incontinence in pregnancy in a Nigerian population: A prospective longitudinal study.

There are several studies from sub-Saharan Africa on postpartum urinary incontinence and anal incontinence, but very rare in pregnancy. Such data will guide obstetric caregivers in providing appropriate counseling to the women as well as in minimizing the risk factors. This study aimed to determine the comparative effects of different trimesters of pregnancy on urinary incontinence and anal incontinence, and their possible risk factors. The study was longitudinal in design, and the study population consisted of 223 pregnant women receiving care at the two largest tertiary health institutions in Enugu, South-East Nigeria. The recruitment was in the first trimester and the women were followed up to term. Interviews were conducted at specific times in the three trimesters and data regarding urinary incontinence and anal incontinence symptoms were obtained using validated questionnaires. The incidence of urinary incontinence increased across the trimesters: 22%, 30.5%, and 48% in the first trimester, second, and third trimesters, respectively, with a cumulative incidence rate of 50.2%. The incidence of anal incontinence also increased across the trimesters but not as high as urinary incontinence: 1.7%, 3.6%, and 5.8%, respectively, with a cumulative incidence rate of 6.7%. The risk factors for urinary incontinence were maternal age >35 years, multiparity, previous prolonged second-stage labor, and previous history of neonatal macrosomia, while that of anal incontinence were previous instrumental vaginal delivery and previous prolonged second stage of labor. Our study demonstrated an increase in the incidence of urinary incontinence and anal incontinence as pregnancy advances. Obstetricians are therefore encouraged to discuss these pelvic floor issues during antenatal care services and make more efforts toward reducing the modifying obstetric risk factors.

Frequency of Stress Urinary Incontinence during Third Trimester in pregnant female with Referral for the Physiotherapy

Introduction 
 .Objectives of the study are:-
 1) To determine the frequency of stress incontinence in pregnant females,
 2) To determine the frequency of urinary incontinence is increased in primigravida (pregnant for first time), or multigravida.
 3) To determine how many of the females are referred for physiotherapy.
 Methodology:
 A Cross-sectional survey was conducted among 600 pregnant females from January to June 2018 selected via the convenience sampling technique. Data was collected from different major cities of Pakistan using validated questionnaires including “The Questionnaire for Urinary Incontinence Diagnosis” (QUID) and “International consultation on incontinence questionnaire” (ICIQ-SF) and self-structured questions assessing the reference of pregnant women to physiotherapy, for urinary incontinence. Subjects were selected according to the inclusion and exclusion criteria with the consent and approval of the participants. Statistical analysis was done using SPSS v.20.
 Results
 Out of 600 females, 84.3% (506/600) had experienced stress urinary incontinence in pregnancy and a 64.5% urinary incontinence was found in multigravida females. According to the results, the complaints of urinary incontinence were increased during the 9th month to 35.5%. 6.2% of the participants were referred to a physiotherapist for exercise, out of which, 3.7% were prescribed daily exercise and 1% followed the exercise regime regularly.
 Conclusion
 This Study concludes that the frequency of stress urinary incontinence in third-trimester pregnant women especially during 9th-month multigravida is severed. Referral to physiotherapy for urinary incontinence in pregnancy is extremely low.

Urinary Incontinence During Pregnancy And Determination Of The Factors Affecting It

Introduction: This study was conducted to determine the prevalence of urinary incontinence in pregnancy and the factors affecting it. 
 Materials and Methods: A total of 300 pregnant women were included. Subjects were examined in terms of physical and sociodemographic characteristics as well as chronic illness status, prenatal and gestational drug use, pelvic trauma and surgical history, chronic cough and smoking, presence of constipation, contraceptive use, obstetric history and urinary incontinence before and during pregnancy. The Sandvik index was used to determine the severity of incontinence in cases having incontinence and the King’s Health Questionnaire was used to assess the quality of life of the incontinent. 
 Results: It was determined that 173 women (%57.7) had urinary incontinence during their pregnancy; and found that having urinary incontinence prior to pregnancy, use of anti-hypertensive in pregnancy, trimester, disuri and fullness sensation of bladder before and during pregnancy and difficulty in urination during pregnancy were the factors affecting incontinence in pregnancy (p0.05). 
 Conclusion: Urinary incontinence in pregnancy is affected by neither advanced physical stresses in the current pregnancy nor by the previous obstetric history; but non-mechanical factors such as the maternal genetic structure and/or hormonal and physiological changes are thought to play role in urinary incontinence development.
 *Presented As The Oral Paper İn The 4th International 5th National Midwifery Congress, master’s thesis

Risk Factors for Urinary Incontinence in Pregnancy: A Case Control Study.

Urinay incontinence (UI) is a major public health problem that can harm women in any period of life, including during the gestational period. Urinary incontinence during pregnancy has been studied because this condition can reduce the quality of life and interfere in several aspects of the maternal-fetal binomial. The aim of this study was to determine the prevalence of UI in nullipara pregnant women and to identify risk factors associated with UI in this population. This is a case-control study in which we invited nullipara women between 12 and 20 weeks of pregnancy to participate in the research. They were asked to answer a specific questionnaire, write a 3-day bladder diary, and undergo a urogynecological evaluation including pelvic organ prolapse quantification (POP-Q), empty stress supine test (ESST), and pelvic floor muscle assessment. A total of 70 out of 73 patients accepted to participate in the study, and the prevalence of UI in this population was 18.3%. Tobacco use was identified as an independent risk factor for UI in pregnant women (odds ratio 8.0). All other factors analyzed were not significantly associated to UI in pregnancy. Urinary incontinence can be a major problem in pregnancy. We identified the use of tobacco as a risk factor for developing UI in pregnancy, which provides an extra reason to encourage patients to quit smoking.

Urinary incontinence in pregnancy and impact on quality of life

Amaç: Araştırma gebelikte üriner inkotinans ve yaşam kalitesini etkileyen faktörleri belirlemek amacıyla yapılmıştır.Gereç ve Yöntem: Araştırma kesitsel ve ilişki arayıcı olarak yapılmıştır. Araştırmanın örneklemini 523 gebe kadın oluşturmuştur. Verilerin toplanmasında katılımcı tanıtım formu, Bristol Kadın Alt Üriner Yol Semptomları Ölçeği (BKAÜYSÖ) ve Üriner İnkontinans Yaşam Kalitesi Ölçeği (ÜİYKÖ) kullanılmıştır.Bulgular: Araştırmada gebelerin yarısından fazlası üriner inkontinans problemi yaşadığını ifade etmiştir. Araştırmada BKAÜYSÖ ile gebelik sayısı, gebelik haftası, küretaj olma, doğum şekli, konstipasyon, gebelikte sigara kullanımı arasında önemli ilişki saptanmıştır (p<0,05). Ayrıca BKAÜYSÖ tüm alt boyutları ile ÜİYKÖ tüm alt boyutları ve toplam puanı arasında negatif yönde önemli ilişki saptanmıştır (p<0,05).Sonuç: Araştırmada gebelikte üriner inkontinans probleminin yaygın olduğu ve gebelikte üriner inkontinans arttıkça yaşam kalitesinin azaldığı belirlenmiştir.

Vitamin D and stress urinary incontinence in pregnancy: a cross-sectional study.

To assess the association between levels of vitamin D and urinary incontinence (UI) in pregnancy. A cross-sectional study. Secondary analysis of a randomised controlled trial. Two university hospitals in Norway. A total of 851 healthy, pregnant women >18years in gestational weeks 18-22 with a singleton live fetus. Data on UI were collected from a questionnaire at inclusion and serum analysis of 25-hydroxy vitamin D (25(OH)D) was performed. Univariable and multivariable logistic regression analyses were applied to study associations between exposure and outcomes. Prevalence of self-reported UI, stress (SUI) and urge (UUI) or mixed UI. In total, 230/851 (27%) of the participants were vitamin D insufficient (25(OH)D <50nmol/l) and 42% reported to have any UI. Women with 25(OH)D <50nmol/l were more likely to report any UI (P=0.03) and SUI (P<0.01) compared with women with 25(OH)D ≥50nmol/l. In a univariable logistic regression analysis, serum levels of 25(OH)D <50nmol/l was associated with increased risk of any UI (odds ratio [OR] 1.5 with 95% CI 1.0-2.1), SUI only (OR 1.7, 95% CI 1.2-2.4), but not mixed UI or UUI only (OR 0.8, 95% CI 0.5-1.5). In a multivariable logistic regression model, serum levels of 25(OH)D <50nmol/l were associated with a higher risk of experiencing SUI only (OR 1.5, 95% CI 1.1-2.2). Serum 25(OH)D <50nmol/l was associated with increased risk of any UI, and SUI in particular. Low levels of vitamin D are associated with increased risk of urinary incontinence in pregnancy.

The burden of urinary incontinence in late pregnancy: Antenatal clinic experience in a tertiary hospital in Northern Nigeria

Background: Urinary incontinence is an under-diagnosed and underreported problem especially among women living in developing countries. Pregnancy is one of the most consistent risk factors in the development of urinary incontinence in women with prevalence increasing with gestational age; being more marked in the late second and third trimester resulting in detrimental effects on the quality of life women live. The objective of this study was to determine the prevalence of urinary incontinence in late pregnancy and help identify women at risk who would benefit from interventions during and after pregnancy. Patients and Method: This was a cross-sectional study that was conducted to determine the prevalence of urinary incontinence in late pregnancy using a structured interviewer administered questionnaire. Respondents were recruited from the antenatal clinic of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. The result was analyzed using SPSS version 20. Results: The prevalence of urinary incontinence was found to be 26.20% with the majority of the respondents having symptoms in keeping with stress urinary incontinence (57.2%) while 34.1% had urgency urinary incontinence and 8.6% had mixed urinary incontinence. Conclusion: There is a high prevalence of urinary incontinence in pregnancy in our environment with every 1 in 5 women being affected. The antenatal period is an opportunity to identify such patients so as to ensure continuity of care and effective referral in order to improve outcome in women at risk.

Treatment of Refractory Urinary Urgency, Frequency, and Incontinence in Pregnancy

The prevalence of urinary symptoms such as urgency, frequency, and urge incontinence is high in pregnancy and often becomes more bothersome further in pregnancy. First-line treatment often includes behavioral modifications such as avoidance of caffeine and timed voiding. Treating incontinence refractory to these first-line measures poses a challenge to the clinician given the concern for fetal harm, miscarriage, and preterm labor from current treatment modalities. The purpose of this review article is to summarize the most up-to-date literature of second- and third-line treatment options for urge incontinence in pregnancy as well as address the known and theoretical risks. The etiology of urge incontinence in pregnancy remains poorly understood and is likely multifactorial. Pelvic floor physical therapy, oral medications, and sacral neuromodulation have been used during pregnancy with some efficacy and outcome reporting. The use of percutaneous tibial nerve stimulation or intradetrusor onabotulinum toxin A injections specifically for the treatment of overactive bladder in pregnancy has not been reported. The current data is limited and comes mostly from case studies/series and registry data. With the exception of pelvic floor physical therapy, limited evidence exists to recommend one treatment modality over another in pregnancy. The safety prolife of oral medications, onabotulinum toxin A injections, and neural modulation in pregnancy has not been conclusively established. The decision to use one of these treatments during pregnancy must weigh the known and theoretical risks against the potential benefits and include informed decision making with the patient.

Prevalence and risk factors for urinary incontinence in pregnancy in Ikere-Ekiti, Nigeria.

The objective of this study was to determine the prevalence and associated risk factors for urinary incontinence (UI) among antenatal clinic attendees in a low resourced setting in Nigeria. This study was a cross-sectional study involving pregnant women aged 18-45 years. Data was obtained from 442 pregnant women using the English version International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short form (ICIQ-UI-SF) from July 2017-September 2017. The questionnaires were self-administered. Data was analyzed with SPSS version 20. Logistic regression was also used to derive the adjusted odds ratio for risk factors of urinary incontinence among the respondents. A P-value <0.05 was taken as statistically significant. The prevalence of urinary incontinence in this study was 28.1%. UI prevalence among the nulliparous and multiparous women were 28.7% and 27.7% respectively. Stress urinary incontinence was the commonest (17.4%) while sexual relation was the most affected lifestyle (22.6%). Overweight (AOR 1.39, P = 0.03), obesity (AOR 1.60, P = 0.009), third trimester (AOR 2.09, P = 0.011), previous instrumental vaginal delivery (AOR 11.54, P < 0.001), Ibo tribe (AOR 3.29, P = 0.006); and Ebira tribe (AOR 8.86, P = 0.028) were associated with UI in pregnancy. Urinary incontinence affects more than a quarter of pregnant women; with substantial lifestyle changes; and sexual relation is the most affected activity. Health care providers should endeavor to enquire about symptoms of UI among pregnant women. Efficacy of interventions needs to be investigated in this population.

Multiparity, age and overweight/obesity as risk factors for urinary incontinence in pregnancy: a systematic review and meta-analysis.

Multiparity, age and high body mass index (BMI) are the most widely investigated factors associated with urinary incontinence (UI) during pregnancy. We hypothesized that multiparity, age 35years or older and high BMI (prepregnancy and during pregnancy) are risk factors for the occurrence of UI in pregnant women. Searches were done on MEDLINE/PubMed (1966-2017), LILACS/BIREME (1982-2017), CINAHL/Ebsco (1981-2017) and Scopus/Elsevier (1950-2017). The following criteria were used for study eligibility: (1) population: low-risk pregnant women in any trimester and without age restriction; (2) exposure factors: multiparity (≥ 2 deliveries), age 35years or older and high BMI (overweight and obesity); (3) outcome: UI during pregnancy; (4) study design: cohort, case-control or cross-sectional studies that used multivariate logistic analysis. Two independent reviewers performed the entire systematic review process. Data extraction of each article was done and, when possible, included in a meta-analysis. Risk of study bias was assessed by NOS and quality of evidence by GRADE. A significance level of p ≤ 0.05 was adopted. The PROSPERO registration number was CRD42014013193. Of 1176 articles identified through searches, 13 were included after screening and application of eligibility criteria. Very low quality of evidence shows that multiparity (OR = 2.09; 95% CI: 1.07 to 4.08), age 35years or older (OR = 1.53; 95% CI: 1.45 to 1.62) and overweight and obesity during pregnancy (OR = 1.53; 95% CI: 1.28 to 1.83) are risk factors for UI in pregnancy. The exposure factors investigated are risk factors for UI in pregnancy based on a very low quality of evidence.

Assessment of Urinary Incontinence in Pregnancy and Postpartum: Observational Study

The urinary incontinence can affect up to 50% of women at some stage of their lives, particularly during pregnancy and postpartum. This study was designed in order to identify and assess the prevalence and risk factors for urinary incontinence during the third trimester of pregnancy and three months postpartum. Observational and cross-sectional study. The population of the study was composed of 268 women who delivered and were admitted to the Centro Hospitalar Tâmega e Sousa in the years 2013 and 2014, and who agreed to participate in this study. Postpartum women were asked to fill out a questionnaire adapted from the International Consultation on Incontinence Questionnaire - Short Form, for urinary incontinence research in the third trimester of pregnancy. Three months after delivery, they were contacted by telephone and asked to answer the same questions about the urinary incontinence postpartum. Of the 268 women interviewed, 31 were excluded from the study, taking into account the defined inclusion and exclusion criteria. In total (n = 237), 51.89% of women included in the study, reported the occurrence of urinary incontinence during pregnancy. The prevalence of urinary incontinence in pregnancy by parity (primiparous versus multiparous) was statistically significant (p = 0.006). At postpartum (n = 237), 28.69% of women with urinary incontinence had vaginal delivery and 5.91% of women underwent cesarean delivery (p = 0.001). In these group of women with postpartum urinary incontinence (n = 82), 31.69% have had urinary incontinence only in the postpartum and 68.31% of women have had symptoms during pregnancy (p < 0.001). This study demonstrates the high prevalence of urinary incontinence in pregnancy and the respective decrease in postpartum. Multiparity and occurrence of urinary incontinence in pregnancy appear as potential risk factors in the emergence of the urinary incontinence.

Effect of Delivery and Episiotomy on the Emergence of Urinary Incontinence in Women: Review of Literature

Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed medio-laterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from injuries. However, reports claiming that episiotomy had no such benefits were published. It was shown that routine medio-lateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased. The role of episiotomy in development of pelvic floor dysfunction remains quite unclear. Due to the mentioned reason, restricted episiotomy approach should be accepted. The origin of stress incontinence during pregnancy is controversial and not definitely scientifically proven. Pregnancy per se and older age at first delivery may have impact on the onset of pelvic floor dysfunction. Urinary incontinence in pregnancy increases the risk of later urinary incontinence, both postpartum and later in life. Vaginal delivery is just one of the potential risk factors for development of urinary incontinence. Mechanical pressure by fetus on the pelvic floor structures, limited denervation of the pelvic floor and soft tissue damage during delivery are some of explanations for the onset of stress urinary incontinence. On the other hand, cesarean delivery might not be protective against emergence of urinary incontinence. Further research in this field is needed.

Gestational Diabetes Mellitus and Risk Factors Associated with Urinary Incontinence in Pregnancy.

Gestational Diabetes Mellitus and Risk Factors Associated with Urinary Incontinence in Pregnancy.

Fisioterapia en incontinencia urinaria de embarazo y posparto: una revisión sistemática

ObjectivesTo perform a systematic review by accessing the most popular health sciences databases in order to search for current scientific evidence on physiotherapy as a treatment for urinary incontinence in pregnancy and the pospartum period. Material and MethodsWe searched Pubmed, the Cochrane Library, SciELO and Google Scholar for articles providing an overview of both the disease and its physiotherapy treatment. The following key words were selected, among others: ‘pregnancy incontinence’, ‘pospartum urinary incontinence’ and ‘physiotherapy for urinary incontinence in pregnancy’. We selected 20 articles that met the requirements established for the systematic review. ResultsObstetric physiotherapy provides a number of benefits to the pelvic floor, helping to cure or significantly reduce symptoms of urinary incontinence. To achieve this improvement, direct supervision of the rehabilitation program by an expert physiotherapist seems to be essential. ConclusionObstetric physiotherapy is an effective preventive and/or treatment method for urinary incontinence in pregnancy and the pospartum period, helping to restore the functionality of the pelvic floor. Further studies are needed to demonstrate its long-term effects.

Errata

BJOG: An International Journal of Obstetrics & GynaecologyVolume 119, Issue 12 p. 1553-1553 Free Access Errata This article corrects the following: The prevalence of urinary incontinence in pregnancy among a multi-ethnic population resident in Norway K Bø, G Pauck Øglund, L Sletner, K Mørkrid, AK Jenum, Volume 119Issue 11BJOG: An International Journal of Obstetrics & Gynaecology pages: 1354-1360 First Published online: July 25, 2012 First published: 11 October 2012 https://doi.org/10.1111/1471-0528.12037AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat In the following article1 there was an error in the sentence ‘Out of 823 women identified in the first trimester, 722 (74%) agreed to participate in the study at 28 weeks gestation’ within the abstract. The correct sentence is: ‘Out of 823 women identified in the first trimester, 772 (94%) agreed to participate in the study at 28 weeks gestation’ We apologise for this error. Reference 1 Bø K, Pauck Øglund G, Sletner L, Mørkrid K, Jenum AK. The prevalence of urinary incontinence in pregnancy among a multi-ethnic population resident in Norway. BJOG 2012; 119: 1354– 60.DOI: 10.1111/1471-0528.12037. Volume119, Issue12November 2012Pages 1553-1553 ReferencesRelatedInformation

The prevalence of urinary incontinence in pregnancy among a multi‐ethnic population resident in Norway

To investigate prevalence of urinary incontinence (UI) in a multi-ethnic population of pregnant women, and to analyse for possible associations of the known risk factors for UI in such a population. Population-based cross-sectional study. All pregnant women in three administrative city districts attending the Child Health Clinics. Out of 823 women identified in the [corrected] first trimester, 772 (94%) [corrected] agreed to participate in the study at 28 weeks of gestation. Inclusion criteria were: healthy women at 20 weeks of gestation or less and able to communicate in Norwegian, Arabic, English, Sorani, Somali, Tamil, Turkish, Urdu or Vietnamese. Differences between ethnic groups were tested by simple descriptive statistics. Associations were estimated by logistic regression analysis and presented as crude (cOR) and adjusted (aOR) odds ratios. Prevalence of UI as ascertained using the International Consultation on Incontinence Questionnaire-urinary incontinence-short form. Prevalence rates of UI at 28 weeks of gestation were 26% for women of African origin, 36% for women of Middle Eastern origin, 40% for women of East Asian origin, 43% for women of South Asian origin and 45% for women of European/North American origin. The difference was significant between women of African and European/North American origins (P = 0.011) and between women of African and South Asian origins (P = 0.035). Age (aOR 1.05; 95% CI 1.01-1.09) and parity (aOR 2.34; 95% CI 1.66-3.28) were positively associated with the prevalence of UI in pregnancy. Women of African origin had significantly reduced odds for UI (aOR 0.42; 95% CI 0.20-0.87). East Asian and African women reported the highest perceived impact of UI in pregnancy. A high prevalence of UI was found in a multi-ethnic pregnant population.

Double incontinence in a cohort of nulliparous pregnant women

To estimate the frequency of double incontinence, and to identify associated risk factors during pregnancy and postpartum in previously continent nulliparous women. A cohort study in healthy, nulliparous, continent pregnant women, attending the public healthcare system of Catalonia (Spain) was designed. The field work was conducted during the control visits of pregnancy, at the time of delivery, and in the postpartum. Double incontinence was defined as a situation in which participants reported simultaneously urinary incontinence (UI) and anal incontinence with the help of a self-administered questionnaire. Prevalence rates, and their corresponding confidence intervals (95% CI), were calculated, as well as the impact on daily life. Multivariable logistic regressions in pregnancy and postpartum were estimated to assess the association of potential risk factors. The prevalence rate of double incontinence during pregnancy was 8.6% (95% CI: 7.0-10.3). Age over 35 years, and family history of UI were associated to a higher risk of double incontinence. After delivery, the prevalence rate decreased to 3.5% (95% CI: 2.4-4.6); only 6.7% of women with double incontinence in pregnancy had a persistency of their symptoms in early postpartum. Instrumental vaginal deliveries carried 2.2 times more risk of double incontinence than spontaneous ones. Episiotomy implied a higher risk for double incontinence. Symptoms of double incontinence are prevalent during first pregnancy; age and other intrinsic factors may favor the occurrence of double incontinence throughout gestation, while instrumental delivery and episiotomy increase the risk of double incontinence in the postpartum period.