Stress urinary incontinence: Prevalence among nulliparous compared with primiparous and grand multiparous premenopausal women

The study was conducted to assess the prevalence of stress urinary incontin ence in pre menopausal nulliparae, primiparae, and grand multiparae, and to examine possible obstetric risk factors. Three hundred consecutive nullipa rae, primiparae, and grand multiparae, 20 to 43 years of age, were intervie wed during the third postpartum day of their consequent delivery about the symptom of stress urinary incontinence. Women were asked whether they had e xperienced stress urinary incontinence before, during, or after previous pr egnancies and how troubled they were by their incontinence. Details of gene ral and gynecologic history, parity, mode of previous deliveries, and birth weights were sought. Main outcome measures included prevalence of pregnanc y-related and (persistent) nonpregnancy-related stress urinary incontinence . Prevalence of persistent stress urinary incontinence was significantly hi gher in grand multiparae compared with nulliparae (21% vs. 5%, respectively ; P = 0.0008). Prevalence of persistent stress urinary incontinence among g rand multiparae who had been delivered of at least one baby weighing more t han 4,000 g was significantly higher than in those who did not (29.4% vs. 1 6.7%, respectively). The birth weight of the first newborn and operative va ginal delivery were not found to be associated with increased risk of stres s urinary incontinence. Grand multiparity was found to be associated with a n increased risk of developing persistent stress urinary incontinence durin g reproductive ages. The delivery of at least one baby weighing more than 4 ,000 g seems to be a predominant factor. (C) 1999 Wiley-Liss, Inc.