title: Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus.
abstract: OBJECTIVE
  To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery.
  
  
  METHODS
  Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes and 98 women without the disease were screened for incontinence and vaginal pressure. Multiple logistic regression models were used to evaluate the independent effects of gestational diabetes.
  
  
  RESULTS
  The prevalence of gestational incontinence was higher among women with gestational diabetes during their pregnancies (50.8% vs. 31.6%) and two years after a cesarean (44.8% vs. 18.4%). Decreased vaginal pressure was also significantly higher among women with gestational diabetes (53.9% vs. 37.8%). Maternal weight gain and newborn weight were risk factors for decreased vaginal pressure. Maternal age, gestational incontinence and decreased vaginal pressure were risk factors for incontinence two years after a cesarean. In a multivariate logistic model, gestational diabetes was an independent risk factor for gestational incontinence.
  
  
  CONCLUSIONS
  The prevalence of incontinence and decreased vaginal pressure two years post-cesarean were elevated among women with gestational diabetes compared to women who were normoglycemic during pregnancy. We confirmed an association between gestational diabetes mellitus and a subsequent decrease of vaginal pressure two years post-cesarean. These results may warrant more comprehensive prospective and translational studies.
authors.affiliation: Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil.
authors.forename: Angélica Mércia Pascon
authors.initials: AM
authors.lastname: Barbosa
authors.forename: Adriano
authors.initials: A
authors.lastname: Dias
authors.forename: Gabriela
authors.initials: G
authors.lastname: Marini
authors.forename: Iracema Mattos Paranhos
authors.initials: IM
authors.lastname: Calderon
authors.forename: Steven
authors.initials: S
authors.lastname: Witkin
authors.forename: Marilza Vieira Cunha
authors.initials: MV
authors.lastname: Rudge
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002585:Cesarean Section / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D053580:Muscle Strength / Q000502:physiology; D010298:Parity; D011247:Pregnancy; D011312:Pressure; D015995:Prevalence; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D014621:Vagina / Q000503:physiopathology*