title: Urinary incontinence 4 and 12 years after first delivery: risk factors associated with prevalence, incidence, remission, and persistence in a cohort of 236 women.
abstract: OBJECTIVE
  Our aim was to study risk factors associated with prevalence, incidence, and remission of UI 4 and 12 years after first delivery.
  
  
  METHODS
  Seven hundred seventy-four nulliparous women who gave birth in 1996 in two French maternity units at term received a questionnaire about their urinary symptoms in 2000 and again in 2008. Two hundred thirty-six women returned a questionnaire about UI 4 and 12 years after first delivery. Four groups of women were built: (A) women continent 4 and 12 years after first delivery; (B) women continent at 4 and incontinent at 12 years; (C) women incontinent at 4 and continent at 12 years; and (D) women incontinent at 4 and 12 years. Multivariate logistic regressions were used to determine risk factors of UI prevalence (groups B + D vs. A + C), incidence (B vs. A), remission (C vs. D), and onset of UI (D vs.
  Factors associated with UI 12 years after first pregnancy were: BMI (OR = 1.17 [95%CI: 1.04-1.32], by 1 kg/m(2) ) and increasing BMI (1.43 [1.19-1.73]), first child's weight (1.08 [1.001-1.16], by 100 g) and UI during first pregnancy (3.77 [1.83-7.76]). Factors associated with UI incidence were age at first delivery (0.86 [0.75-0.98]) and high BMI (1.24 [1.05-1.45]). Increasing BMI, UI during first pregnancy, and heavy first child reduce the likelihood of UI remission (0.37 [0.20-0.68], 0.11 [0.02-0.63], and 0.73[0.59-0.91], respectively).
  
  
  CONCLUSIONS
  UI during first pregnancy could be indicative of individual susceptibility to UI. Obesity appears to be a modifiable factor for remission of UI in women.
authors.affiliation: INSERM, UMR S953, Epidemiological research unit on perinatal health and women's' and children's health, Paris, France; Department of Gynaecology, Obstetrics, Intercommunal Hospital Center of Poissy-Saint-Germain-en-Laye, Poissy, France.
authors.forename: Anne-Cécile
authors.initials: AC
authors.lastname: Pizzoferrato
authors.forename: Arnaud
authors.initials: A
authors.lastname: Fauconnier
authors.forename: Emeline
authors.initials: E
authors.lastname: Quiboeuf
authors.forename: Karine
authors.initials: K
authors.lastname: Morel
authors.forename: Jean-Patrick
authors.initials: JP
authors.lastname: Schaal
authors.forename: Xavier
authors.initials: X
authors.lastname: Fritel
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D015995:Prevalence; D012074:Remission Induction; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000453:epidemiology*
keywords: age; body mass index; mode of delivery; parity; urinary incontinence