**1. Introduction**

20 Urinary Incontinence

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Urinary incontinence is a common condition in pregnancy and postpartum. There are published more than a thousand articles on urinary incontinence (UI) in pregnancy. Incidence and prevalence figures of UI in association with pregnancy vary substantially.

Not many reviews have focused solely on incidence and prevalence of UI in association with pregnancy. One report gives a range of prevalence of UI in pregnancy from 32 to 64 % (Milsom et al., 2009). There are published few reviews on incident UI postpartum, most of them are based on a small number of studies. However, one systematically review (Thom & Rortveit, 2010) and several traditional reviews have been published on prevalence of UI postpartum.

This chapter on epidemiology of urinary incontinence in pregnancy and postpartum reviews the incidence and prevalence of UI in pregnancy and postpartum on the basis of a non-systematic PubMed search. The selected articles are chosen due to relevance, quality, citation and sample size.

Published articles will be listed in tables. Tables will contain data on author and article, country of origin of the study, type of study, number of participants, time point in pregnancy and postpartum of information gathering, means of information gathering (questionnaire, interview, objective testing), and prevalence and incidence figures. Parity is an established risk factor for UI. Tables will therefore be stratified for primiparous and parous women. Large studies of good quality are referred to in the text. We will summarize incidence and prevalence figures from single papers; both range of all figures and a more narrow range of figures without the two highest and lowest outliers will be given. We will also give estimates from former reviews.

Prevalence and incidence estimates of UI in association with pregnancy vary very much and with a factor of 7 – 10. We will discuss study design, characteristics of the study population, biases, definitions and other methodological reasons for the diverging estimates, and try to help the reader understand why estimates differ. Hopefully this will give a better

Epidemiology of Urinary Incontinence in Pregnancy and Postpartum 23

**collection** 

Jordan Cohort 181 Interv. . 3. trimester 45 % 54 %

Spain Cohort 396 Ex., interv. Delivery 31 %

interv.

Cross-S 304 Interv. During

Sweden Cohort 665 Quest. 3. trimester 45 %

Israel Cross-S 300 Interv. 3 days PP 28 % 49-50%

Denmark Cross-S 642 Quest. 17 % 8 %

Sweden Cohort 200 Quest. 3. trimester 14 %

UK Cross-S 7,771 Quest. 3 days PP 50 % 45 %

India Cohort 240 Quest. 3. trimester 18 %

Denmark Cohort 305 Interv. 1 week PP 10 % (s)

Norway Cohort 43,279 Quest. 3. trimester 39 % 49 %

Germany Cross-S 180 Interv. During

UK, N.Z. Cross-S 3,405 Quest. During

(Iosif, 1981) Sweden Cohort 1,411 Ex, interv. 1-2 weeks PP 5 %(s)

UK Cohort 103 Ex, interv. During

Norway Cross-S 144 Ex., interv. During

Spain Cohort 1,128 Quest. During

USA Cross-S 121 Ex., interv. During

cross-s = cross sectional study, Quest. = Questionnaire, Interv. = interview, Ex. = examination, PP =

Table 1. Incidence of urinary incontinence in pregnancy by parity.

**Time of UI Nulli-**

3. trimester 45 %

pregn.

pregn.

pregn.

pregn.

pregn.

pregn.

pregn.

**parous** 

**Parous** 

57 %

54 %

11 %

48 %

39 %

16 %

(s)

 38 %(s)

**Authors, year Origin Design N Data** 

New - Zealand

Australia Cohort 1,507 Quest.,

(Al-Mehaisen et al., 2009)

(Arrue et al., 2010)

(Brown et al.,

(Chiarelli & Campbell, 1997)

(Dimpfl et al.,

(Eliasson et al.,

(Glazener et al.,

(Groutz et al.,

(Hvidman et al.,

(Kristiansson et al., 2001)

(Marshall et al.,

(Morkved & Bo,

(Sharma et al.,

Domenech et al.,

(Thomason et al.,

(Viktrup et al.,

(Wesnes et al.,

postpartum, (s) = stress UI

2010)

1992)

2005)

2006)

1999)

2002)

1998)

1999)

2009)

2010)

2007)

1992)

2007)

(Solans-

(King & Freeman, 1998)

understanding of incidence and prevalence estimates of urinary incontinence in association with pregnancy.
