The prevalence of stress incontinence during pregnancy and following delivery

Objectives: to examine the variation in findings from epidemiological studi es which describe the prevalence of stress incontinence during and after pr egnancy, and to undertake a prospective survey of the prevalence of stress incontinence during pregnancy and following childbirth in order to provide clarification of the findings presented in the literature, Design: a review of the literature was undertaken using the Medline and Pop line CD Rom, A postal questionnaire was sent to a sample of women when they reached 34 weeks' gestation and repeated at 8 weeks postpartum. Participants: 1008 women were recruited to the study when they attended the antenatal clinic at two hospitals in the north west of England, Seven hund red and seventeen (71%) women responded to the first questionnaire and 572 (57%) completed the second questionnaire. Findings: the prevalence of stress incontinence during pregnancy reported i n the literature ranges from 20 to 67%. Following delivery the reported pre valence is between 6 and 29%, In the present study 59% of women reported st ress incontinence during pregnancy, and 31% following delivery. Ten per cen t of the women had daily episodes of incontinence during their pregnancy, 2 % of all women reported daily incontinence following delivery. An associati on was found between parity and stress incontinence, with women of higher p arity being more likely to experience the condition. No difference in the p revalence of stress incontinence was found between women who had a normal d elivery and those having an instrumental delivery. A caesarean section was found to be associated with a lower incidence of stress incontinence compar ed with a normal spontaneous delivery. Key conclusion: a high proportion of women experienced stress incontinence during pregnancy and/or following delivery. Some women reported severe symp toms, with leakage on a daily basis. Women of higher parity were more likel y to suffer from the condition,Whilst women who had a normal spontaneous de livery or an instrumental delivery reported a similar level of stress incon tinence, women who had a caesarean section were less likely to have the con dition.