Incontinence in pregnancy linked to later problem

NEW YORK (Reuters Health) - Women who suffer from urinary incontinence in their first pregnancy or in the period after delivery have an increased likelihood of developing long-lasting incontinence, according to a new study.

Dr. Lars Viktrup, of Eli Lilly and Company, Indianapolis, Indiana, and colleagues asked 241 women to complete questionnaires regarding stress urinary incontinence -- urine loss triggered by a physical stress such as coughing or laughing -- during and after their first pregnancy and 12 years later.

As reported in the medical journal Obstetrics and Gynecology, 102 of the women (42 percent) reported stress urinary incontinence 12 years after first delivery. The prevalence of urinary incontinence at the 12-year mark was significantly higher among women who had onset during first pregnancy and those with onset shortly after delivery than for women without initial symptoms -- 56 percent and 78 percent, versus 30 percent.

"In 70 women who had onset of stress urinary incontinence during the first pregnancy or the first 3-month puerperal period but remission 3 months postpartum, a total of 40 (57 percent) had stress urinary incontinence 12 years later," Viktrup and colleagues report.

However, among the 11 women with pregnancy-related incontinence but no remission after 3 months, 10 (91 percent) had stress urinary incontinence 12 years later.

The investigators say it's not clear exactly what may trigger incontinence during pregnancy or immediately after. Hormonal changes may play a role, or it may result from injuries to the muscles, nerves, or connective tissue supporting the lower urinary tract and pelvic floor that may occur with vaginal delivery.

SOURCE: Obstetrics and Gynecology, August 2006.