The impact of gestational diabetes mellitus on postpartum urinary incontinence: a longitudinal cohort study on singleton pregnancies.
OBJECTIVE
To determine whether gestational diabetes mellitus (GDM) is an independent risk factor for postpartum urinary incontinence in singleton pregnancies.


METHODS
A longitudinal cohort study.


METHODS
A single tertiary-care hospital in Taiwan.


METHODS
Pregnant women with term deliveries between 2002 and 2007 (n = 6653) were consecutively recruited.


METHODS
Logistic regression models were fitted based on generalised estimating equation methods to derive odds ratios for occurrences of type-specific urinary incontinence in the third trimester and at four time-points over 2 years during the postpartum period.


METHODS
Evaluation of whether GDM is an independent risk factor for postpartum urinary incontinence.


RESULTS
The full model analysis revealed that GDM was an independent risk factor for all type-specific urinary incontinence (odds ratio [95% confidence interval]: 1.97 [1.56-2.51], 3.11 [2.18-4.43] and 2.73 [1.70-4.40] for stress, urge and mixed incontinence, respectively]. Compared with women without GDM, women with GDM tended to exhibit more severe symptoms of stress incontinence for up to 2 years postpartum, whereas for urge or mixed incontinence, more severe symptoms were found only for 6 months postpartum. Evaluation of quality of life using the Incontinence Impact Questionnaire 7 suggested that women with GDM requiring insulin treatment had a higher likelihood of functional impairment than women with GDM requiring conservative treatment only or women without GDM (P < 0.05, by the chi-square test for trend).


CONCLUSIONS
GDM was found to be an independent risk factor for postpartum urinary incontinence and had a significant impact on quality of life. Women with GDM should be provided with timely consultation and support once urinary incontinence occurs.
Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
C-M
CM
Chuang
I-F
IF
Lin
H-C
HC
Horng
Y-H
YH
Hsiao
I-L
IL
Shyu
P
P
Chou
D000293:Adolescent; D000328:Adult; D048909:Diabetes Complications / Q000453:epidemiology*; D016640:Diabetes, Gestational; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011644:Puerperal Disorders / Q000209:etiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000209:etiology*; D055815:Young Adult