The prevalence of bender added with age (Table 3). As abounding as 3,083 (15.4%) nulliparous women appear bender afore pregnancy. However, the prevalence was decidedly college amid abundant women, as 4,662 (33%) primiparous women and 3,549 (40%) multiparous women appear incontinence. The prevalence additionally added with accretion BMI (Table 3). Adapted analyses showed an attenuated affiliation amid age and bender as compared with unadjusted analyses, admitting agnate after-effects for BMI and adequation about remained the aforementioned (Table 3).
Urinary bender was appear by 25,121 (58.1%) women during abundance (Table 1). Accent urinary bender was the best accepted type, appear by 6,171 (30.9%) nulliparous and 9,790 (42.0%) abundant women. Amid women who were abstemious afore pregnancy, the accumulative accident of any bender was 45.6% (13,978/30,631) by anniversary 30 of pregnancy. The accumulative accident was 31.5% (9,634/30,631), 4.0% (1,231/30,631), and 10.2% (3,113/30,631) for stress, urge, and alloyed incontinence, respectively.
Weekly arising or added was appear by 9,373 (21.7%) in affiliation with coughing or laughing, by 2,839 (6.5%) in affiliation with active or jumping, and by 3,228 (7.5%) who had affection associated with coercion (Table 2). During pregnancy, arising of aerosol was abundant added accepted than arising of beyond amounts behindhand of triggering situation, with 2,140 (4.9%), 966 (2.2%), and 919 (2.1%) aperture “larger amounts,” respectively.
The prevalence of bender in abundance added with accretion parity, BMI, and age (Table 3). Amid nulliparous women, 9,586 (48.0%) were amoral during pregnancy; still, the prevalence was decidedly college amid abundant women (66.6%). Adapted analyses resulted in alone accessory abridgement in ORs for all variables in the model.
When comparing urinary bender afore and during abundance in Table 1, the admission in prevalence is two-fold for SUI and three-fold for alloyed urinary bender (Table 1). “Coughing, laughing, or sneezing” was the bearings best acerb associated with an admission of prevalence of urinary bender during pregnancy. Table 2 shows that the admission in prevalence of affection during abundance was predominantly due to slight affection (Frequency “1–4 times a month” or “1–6 times a week” and “Droplets” for amounts).
Even admitting the complete abstracts for urinary bender were abundant college in pregnancy, the about associations amid bender and age or BMI were agnate afore and during pregnancy. The affiliation amid bender and parity, however, was weaker in abundance than before, and abnormally so for women of adequation 2 or added (Table 3). However, adequation still remained a able accident agency for urinary bender in pregnancy.
In this ample citizenry of abundant women, the prevalence of any bender was angled compared with the prevalence afore pregnancy. The admission was due to the accent bender component, appropriately accretion SUI and alloyed urinary incontinence. Affection tended to be balmy both afore and during pregnancy. Adequation was a able accident agency amid nonpregnant women, beneath so amid abundant women, admitting age and BMI were anemic accident factors in this citizenry of boyish women.
A above backbone of this abstraction was the admeasurement of the empiric cohort. We did not appear beyond any abstraction this ample apropos bender during abundance back analytic PubMed (English language; January 1966–July 2006; bound to adolescent, adult, average aged; chase agreement “urinary incontinence” and “pregnancy”). Narrow aplomb intervals adequate the attention of the results.
The Norwegian Mother and Child Accomplice Abstraction arrive all abundant women in Norway to participate, accent that the ambition citizenry of MoBa was a population-based and nonselected sample. The acknowledgment bulk was 45%. The abstraction citizenry may not be adumbrative of abundant women during the advised aeon in every respect. There were, however, alone accessory differences amid the MoBa participants and their births compared with the absolute cardinal of births in the aforementioned aeon apropos administration of demographic variables.11 Even admitting the abstraction citizenry was adumbrative of Norwegian abundant women in abounding aspects, it is accessible that there was a socioeconomic acclivity that afflicted prevalence estimates, because women in lower socioeconomic classes were underrepresented. The capital alternative was accompanying to the bulk of recruitment. Accident factors such as age, BMI, and adequation may be broadcast abnormally in low-income abundant women. This may accept alien a bias, best apparently against a lower prevalence than in the absolute population. On the added hand, there is no acumen to accept that there was a alternative bent on the base of bender status, because the MoBa was a analysis accoutrement abounding topics, with urinary bender questions alone actuality a accessory issue. We accept that aftereffect estimates for the accident factors advised in this abstraction were not afflicted by a cogent alternative bias.
Our appraisal of prevalence afore abundance stems from a abundant population, and this may acquaint a bias, based on awareness, against a college prevalence. As mentioned, alternative bent due to ache cachet is absurd to occur. Additionally, ample accomplice studies from Australia and Norway accept appear agnate prevalence of urinary bender amid a accepted citizenry of women age-old 18 to 50 years, with 24.2% and 25.0%, respectively.2,4 A advanced ambit of prevalence abstracts has been presented amid both nulliparous (5–39%) and abundant (19–48%) women.13–15 It does not assume acceptable that there is a ample anamnesis bent consistent in college prevalence of urinary incontinence. Prevalence of bender during abundance additionally varies broadly in antecedent studies, with abstracts alignment from 4–53% amid nulliparous women, and from 14–84% amid abundant women.7,8,14,16–18 Our prevalence appraisal of 58.1% of bender during abundance broadcast anyhow on three types of urinary bender was based on real-time address of affection in a large, unselected population, agnate to abstracts appear in added -to-be studies of abundant women.6,19,20
Epidemiologic abstracts are deficient on accumulative accident of urinary bender during pregnancy. We appear a accumulative accident of 45% of any incontinence, which is college than beforehand appear (12% and 16.7%).14,21 However, both studies were based on anamnesis data, which may accept afflicted the estimate. The admission of bender in abundance was mostly due to added prevalence of SUI and alloyed urinary incontinence. This is in band with allegation in antecedent studies that accept advised the aftereffect of abundance on blazon of incontinence.18,22,23 Several studies on bender during abundance accept appear abstracts on accent bender only, with estimates amid 9% and 85%7,16,22,24,25 The altered prevalence estimates could partly be explained by use of questionnaires at altered credibility during pregnancy, by attendant or -to-be architecture and by use of abstract or cold measurements. Our appraisal of 32.3% was in the average of the appear range. Abundant women were beneath acceptable to run and jump, which may explain why the prevalence of bender in such situations added alone moderately during pregnancy. We acclimated a low severity beginning to accommodate amoral women. Our urinary bender analogue was based on analogue from the International Abandonment Society.12
Although the check itself was not accurately validated, it acclimated the acknowledgment options “Droplets” or “Larger amounts” to admeasurement bulk of leakage. In Norwegian, the accepted compassionate of these answering alternatives would be aing to the commitment in the accurate Sandvik’s Severity Index.26 Few antecedent studies accept looked into changes in severity of affection as a aftereffect of pregnancy. Women in our abstraction about appear balmy symptoms, both afore and during pregnancy. This award is in band with after-effects from added studies.6,8,19,24 This implies that bender in abundance should not be admired as a above botheration as such. However, a contempo abstraction suggests that bender in abundance may be a accident for bender afterwards in life.27
Age, parity, and BMI are three capital accident factors for bender in adolescent women.4,6,7,13–15,17,28 In the present study, adapted analyses showed that adequation was the arch accident agency for urinary bender amid both nonpregnant and abundant women, with OR about 2 for abundant women. This is in band with added studies.19,25,29 Some authors accept begin a assertive beginning for the cardinal of deliveries as accident agency for incontinence.15,30 Our allegation abutment that the aboriginal commitment has the arch aftereffect on urinary bender afore a new pregnancy, but consecutive deliveries additionally add to the accident for incontinence. However, the affiliation with adequation was beneath able amid abundant women, advertence that abundance itself becomes a added important accident agency for bender back pregnant.
Studies accept apparent that accepting bender afore abundance is a cogent accident agency of bender during pregnancy.6,14 It was not hasty that women who were amoral at the alpha of abundance did not get bigger in pregnancy. However, women who had been amoral previously, but were abstemious at the alpha of pregnancy, represent an absorbing group. It is not bright from antecedent studies if this accumulation was at added accident of bender during pregnancy. Our abstracts did not acquiesce us to analyze amid these two groups of women with bender in this situation.
In conclusion, this ample abstraction of abundant women accepted that bender in abundance is awful prevalent. The admission of prevalence compared with the nonpregnant accompaniment was mainly due to accent and alloyed incontinence. Generally, abundant women had balmy symptoms. In pregnancy, adequation was beneath acerb associated with bender compared with the prepregnancy state, apparently because abundance becomes a able accident agency in itself. The accident of longstanding and progressively added astringent bender amid women who were amoral during abundance should be advised in added studies.
Obstetrics & Gynecology109(4):922-928, April 2007.
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