title: The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort study.
abstract: OBJECTIVE
  The objectives of this study were to investigate prevalence of urinary incontinence at 6 months postpartum and to study how continence status during pregnancy and mode of delivery influence urinary incontinence at 6 months postpartum in primiparous women.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Pregnant women attending routine ultrasound examination were recruited to the Norwegian Mother and Child Cohort Study (MoBa).
  
  
  METHODS
  A total of 12,679 primigravidas who were continent before pregnancy.
  
  
  METHODS
  Data are from MoBa, conducted by the Norwegian Institute of Public Health. Data are based on questionnaires answered at week 15 and 30 of pregnancy and 6 months postpartum.
  
  
  METHODS
  Urinary incontinence 6 months postpartum is presented as proportions, odds ratios and relative risks (RRs).
  
  
  RESULTS
  Urinary incontinence was reported by 31% of the women 6 months after delivery. Compared with women who were continent during pregnancy, incontinence was more prevalent 6 months after delivery among women who experienced incontinence during pregnancy (adjusted RR 2.3, 95% CI 2.2-2.4). Adjusted RR for incontinence after spontaneous vaginal delivery compared with elective caesarean section was 3.2 (95% CI 2.2-4.7) among women who were continent and 2.9 (95% CI 2.3-3.4) among women who were incontinent in pregnancy.
  
  
  CONCLUSIONS
  Urinary incontinence was prevalent 6 months postpartum. The association between incontinence postpartum and mode of delivery was not substantially influenced by incontinence status in pregnancy. Prediction of a group with high risk of incontinence according to mode of delivery cannot be based on continence status in pregnancy.
authors.affiliation: Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway. stian.langeland@isf.uib.no
authors.forename: S L
authors.initials: SL
authors.lastname: Wesnes
authors.forename: S
authors.initials: S
authors.lastname: Hunskaar
authors.forename: K
authors.initials: K
authors.lastname: Bo
authors.forename: G
authors.initials: G
authors.lastname: Rortveit
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009772:Obstetrical Forceps / Q000009:adverse effects; D016017:Odds Ratio; D011247:Pregnancy; D011248:Pregnancy Complications; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D015995:Prevalence; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000453:epidemiology / Q000209:etiology*; D012306:Risk; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology*; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects; D055815:Young Adult