Age- and type-dependent effects of parity on urinary incontinence: The Norwegian EPINCONT Study

Department of Public Health and Primary Health Care, University of Bergen, Bergen, Hordaland, Norway
Obstetrics and Gynecology (Impact Factor: 5.18). 01/2002; 98(6):1004-10. DOI: 10.1016/S0029-7844(01)01566-6
Source: PubMed


To investigate the association between parity and urinary incontinence, including subtypes and severity of incontinence, in an unselected sample, with special emphasis on age as a confounder or effect modifier.
This was a cross-sectional study (response rate 80%) with 27,900 participating women. Data on parity and urinary leakage, type, frequency, amount, and impact of incontinence were recorded by means of a questionnaire. A validated severity index was used. Relative risks (RR) with nulliparous women as reference were used as an effect measure.
Incontinence was reported by 25% of participants. Prevalences among nulliparous women ranged from 8% to 32%, increasing with age. Parity was associated with incontinence, and the first delivery was the most significant. The association was strongest in the age group 20-34 years with RR 2.2 (95% confidence interval [CI] 1.8, 2.6) for primiparous women and 3.3 (2.4, 4.4) for grand multiparous women. A weaker association was found in the age group 35-64 years (RRs between 1.4 and 2.0), whereas no association was found among women over 65 years. For stress incontinence in the age group 20-34 years, the RR was 2.7 (2.0, 3.5) for primiparous women and 4.0 (2.5, 6.4) for grand multiparous women. There was an association with parity also for mixed incontinence, but not for urge incontinence. Severity was not clinically significantly associated with parity.
Parity is an important risk factor for female urinary incontinence in fertile and peri- and early postmenopausal ages. Only stress and mixed types of incontinence are associated with parity. All effects of parity seem to disappear in older age.

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Available from: Guri Rortveit, Aug 21, 2014
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    • "However, the reported prevalence of urinary incontinence varies widely both during and after pregnancy. (Rortveit G, et al;2001), (Wesnes SL, et al;2007) In postpartum cases UI is a disorder consisting of incontinence starting before, during and after pregnancy. In the present study, women who had delivered by cesarean section were at higher risk for any incontinence than were nulliparous women. "
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    ABSTRACT: Background: Sexuality can be embarrassing for many people to discuss. The same goes for incontinence. So it can be doubly difficult to address when incontinence gets in the way of a satisfying sex life. This study is to find the relation between the mode of delivery and incontinence, and evaluating sexual dysfunction as a problem of incontinence. Patients and methods: Retrospective study was done on 300 cases department of Obstetrics and Gynecology at Sohag teaching hospital from December 2012 to August 2013.The women were classified into 2 groups , ( group 1 = 150 women ) have previous normal vaginal and(Group 2= 150 women) have previous caesarean section. The presence of urinary incontence and sexual dysfunction was evaluated in both groups. Conclusion: The results of this study have led us to conclude that the risk of urinary incontinence is higher among women who have had vaginal deliveries than among women who have had cesarean sections. The incidence of reporting sexual dysfunction as a problem with urinary incontinence is higher in women with vaginal delivery. Keywords: urinary incontinence, mode of delivery, sexual dysfunctions, problem.
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    • "The association between incontinence and other factors/conditions is less clear. There is conflicting data about the potential roles of education, hysterectomy, constipation, and smoking in the development of incontinence (Correia et al. 2009; Irwin et al. 2006; Serati et al. 2008; Menezes et al. 2010; Rortveit et al. 2001; Waetjen et al. 2007). "
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    ABSTRACT: To estimate the prevalence of urinary incontinence (UI) and to assess its risk factors among postmenopausal Estonian women. In 2004, 1363 women participating in the Estonian Postmenopausal Hormone Therapy Trial were asked at the closure visit to the trial physician about symptoms of UI. The type of incontinence was assessed with the help of a questionnaire, based on recommendations from the working group set up by the Finnish Gynaecological Association. Frequency characteristics were analysed by descriptive statistics. Risk factors were examined using logistic regression. Mean age of study women was 53.3 years (min = 48, max = 67; SD 4.0). The prevalence of UI was 18.12% (95% CI: 16.07 - 20.17). Stress incontinence was diagnosed in 78.83% (95% CI: 73.32 - 84.33) and urge or mixed incontinence in 21.17% (95% CI: 15.67 - 26.68) of women who reported incontinence. Prevalence of UI slightly increased with age. Women who used hormone therapy (HT) (OR 1.67; 95% CI: 1.17 - 2.39), had had hysterectomy (1.73, 95% CI: 1.06 - 2.83), and those with secondary education (OR 1.87, 95% CI: 1.23 - 2.82) or basic education (OR 3.29, 95% CI: 1.80 - 6.02) had a higher risk for UI. Parity, having a BMI over 30 kg/m(2), being a smoker or a former smoker, having diabetes and being physically or sexually active, tended to increase the risk of UI. About one in five postmenopausal women in Estonia reported to have UI. Risk factors linked with UI, its prevalence in other age groups and the impact of UI on quality of life deserve more research. Number: ISRCTN35338757.
    SpringerPlus 10/2013; 2(1):524. DOI:10.1186/2193-1801-2-524
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    • "Urinary incontinence (UI) is common also among women who have not given birth (nulliparous women). A Norwegian study found prevalence of UI among nulliparous women aged 20 – 34 and 35 – 44 to be 8 % and 15 %, respectively (Rortveit et al., 2001). Other studies have found that 11 % (Brown et al., 2010, MacLennan et al., 2000) of nulliparous women had UI before pregnancy. "

    Urinary Incontinence, 04/2012; , ISBN: 978-953-51-0484-1
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