OBJECTIVE: Pregnancy and childbirth are commonly thought to be associated w
ith the development of urinary incontinence and lower urinary tract symptom
s. The purpose of this study was to assess the relationship, if any, betwee
n pregnancy and the development of lower urinary tract symptoms.
STUDY DESIGN: A prospective study of lower urinary tract symptoms was carri
ed out in a cohort of pregnant women who answered a series of symptom quest
ionnaires and kept a 24-hour bladder chart on which frequency of urination
and volumes voided were recorded throughout pregnancy and for 8 weeks after
birth.
RESULTS: A total of 123 women participated in the study. Mean daily urine o
utput (P = .01) and the mean number of voids per day (P = .01) increased wi
th gestational age and declined after delivery Episodes of urinary incontin
ence peaked in the third trimester and improved after birth (P = .001). Whi
te women had higher mean voided volumes and fewer voiding episodes than did
black women. Ingestion of caffeine was associated with smaller voided volu
mes and greater frequency of urination.
CONCLUSION: Pregnancy is associated with an increase in urinary incontinenc
e. This phenomenon decreases in the puerperium. Pregnancy and childbirth tr
auma are important factors in the development of urinary incontinence among
women. These findings warrant further investigation.