Trends in urinary incontinence in women between 4 and 24 months postpartum in the EDEN cohort.
OBJECTIVE
Our aim was to study risk factors associated with the prevalence, incidence and remission of urinary incontinence (UI) between 4 and 24 months postpartum.


METHODS
Longitudinal study (EDEN cohort).


METHODS
Two French university hospitals.


METHODS
1643 women completed the questionnaire at 4 months and 1409 at 24 months, including 1354 who completed it both times.


METHODS
Multivariate analyses identified risk factors for UI prevalence at 24 months postpartum, persistent UI versus remission, de novo UI versus continence, de novo UI versus persistent UI, and changes in IU severity between 4 and 24 months postpartum.


METHODS
Postnatal UI and Sandvik UI severity score.


RESULTS
UI prevalence was 20.7% (340/1643) at 4 months and 19.9% (280/1409) at 24 months. Significant factors associated with UI at 24 months were older age [OR = 1.07/year (95%CI 1.04-1.11)], BMI [2.35 (1.44-3.85) ≥30 versus <25 kg/m²], higher parity [1.77 (1.14-2.76) ≥3 versus 1], breastfeeding [1.54 (1.08-2.19) ≥3 versus < 3 months], pregnant at follow up [3.44 (2.25-5.26)], and caesarean delivery [0.62 (0.40-0.97) versus vaginal] [OR, odds ratio (CI, confidence interval)]. The likelihood of UI remission at 24 months was 51.9% (149/287). Caesarean delivery was associated with increased likelihood of UI remission [0.43 (0.19-0.97)]. The risk of de novo UI at 24 months was 12.5% (135/1067) and was associated with a new pregnancy [3.63 (2.13-6.20)].


CONCLUSIONS
Between 4 and 24 months postpartum UI, remission occurred in half of the cases. These postnatal UI changes were essentially related to mode of delivery and subsequent pregnancy.


CONCLUSIONS
Postnatal urinary incontinence progression is mostly related with mode of delivery and subsequent pregnancy.
CHU de Bordeaux, Université Bordeaux-2, Bordeaux, France.
E
E
Quiboeuf
INSERM U1153, Obstetric, Perinatal and Paediatric Epidemiology Research Team, Research Centre for Epidemiology and Biostatistics Sorbonne-Paris-Cité (CRESS), Paris-Descartes Université, Paris, France.
M-J
MJ
Saurel-Cubizolles
CHU de Poitiers, Université de Poitiers, Poitiers, France.|INSERM CIC1402, Poitiers, France.|INSERM U1018 CESP, Gender, Sexual and Reproductive Health, Kremlin-Bicêtre, France.
X
X
Fritel
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D036861:Delivery, Obstetric / Q000009:adverse effects; D004812:Epidemiologic Methods; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D014549:Urinary Incontinence / Q000453:epidemiology*; D055815:Young Adult
Cohort; female urinary incontinence; incidence; postpartum; pregnancy; remission