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Open Access Research article

Effects of carrying a pregnancy and of method of delivery on urinary incontinence: a prospective cohort study

Erica Eason1*, Michel Labrecque2, Sylvie Marcoux3 and Myrto Mondor4

Author Affiliations

1 Dept. of Obstetrics & Gynaecology, University of Ottawa, Ottawa, Canada

2 Dept. of Family Medicine, Université Laval, Québec, Canada

3 Dept. of Social and Preventive Medicine, Université Laval, Québec, Canada

4 Epidemiology research group, Centre hospitalier affilié universitaire de Québec, Hôpital St-Sacrement, Québec, Canada

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BMC Pregnancy and Childbirth 2004, 4:4  doi:10.1186/1471-2393-4-4

Published: 19 February 2004

Abstract

Background

This study was carried out to identify risk factors associated with urinary incontinence in women three months after giving birth.

Methods

Urinary incontinence before and during pregnancy was assessed at study enrolment early in the third trimester. Incontinence was re-assessed three months postpartum. Logistic regression analysis was used to assess the role of maternal and obstetric factors in causing postpartum urinary incontinence. This prospective cohort study in 949 pregnant women in Quebec, Canada was nested within a randomised controlled trial of prenatal perineal massage.

Results

Postpartum urinary incontinence was increased with prepregnancy incontinence (adjusted odds ratio [adj0R] 6.44, 95% CI 4.15, 9.98), incontinence beginning during pregnancy (adjOR 1.93, 95% CI 1.32, 2.83), and higher prepregnancy body mass index (adjOR 1.07/unit of BMI, 95% CI 1.03,1.11). Caesarean section was highly protective (adjOR 0.27, 95% CI 0.14, 0.50). While there was a trend towards increasing incontinence with forceps delivery (adjOR 1.73, 95% CI 0.96, 3.13) this was not statistically significant. The weight of the baby, episiotomy, the length of the second stage of labour, and epidural analgesia were not predictive of urinary incontinence. Nor was prenatal perineal massage, the randomised controlled trial intervention. When the analysis was limited to women having their first vaginal birth, the same risk factors were important, with similar adjusted odds ratios.

Conclusions

Urinary incontinence during pregnancy is extremely common, affecting over half of pregnant women. Urinary incontinence beginning during pregnancy roughly doubles the likelihood of urinary incontinence at 3 months postpartum, regardless whether delivery is vaginal or by Caesarean section.