Journal of Epidemiology and Community Health, Vol 53, 453-458

Urinary incontinence in middle aged women: childhood enuresis and other lifetime risk factors in a British prospective cohort

D Kuh, L Cardozo and R Hardy
Department of Epidemiology and Public Health, University College London Medical School.

STUDY OBJECTIVE: To investigate the prevalence and lifetime risk factors for urinary incontinence in middle aged women. DESIGN: Nationally representative birth cohort study with prospective data on childhood enuresis, measured adult height and weight, childbearing histories and measures of socioeconomic status updated at regular contacts, and measures of menopausal status, symptomatology and health care in midlife. SETTING: England, Scotland and Wales. PARTICIPANTS: General population sample of 1333 women aged 48 years. MAIN RESULTS: Fifty per cent reported symptoms of stress incontinence and 22% reported symptoms of urge incontinence in the previous year. Eight per cent had severe symptoms. Women who at age 6 years had wet in the day or several nights a week were more likely to suffer severe incontinence and report urge symptoms but occasional bedwetting was not associated with an increased risk in adult life. Those who were older at the birth of their children and who had vaginal deliveries had an excess risk of stress symptoms. Heavier adult body weight was also a risk factor for these symptoms and for severe incontinence. Postmenopausal women were less likely to report stress symptoms. These risk factors remained significant after taking account of the increased reporting of incontinence among women with high levels of general symptomatology and general practitioner visits, and of stress symptoms among better educated women. CONCLUSIONS: Urinary incontinence is a common problem among middle aged women. This is the first prospective study of a general population sample to support the postulated link between childhood enuresis and adult incontinence. Child-bearing has long term adverse effects, particularly for older mothers. Overweight is a common risk factor.

Copyright © 1999 by the Journal of Epidemiology and Community Health
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• McGrother, C. W., Donaldson, M. M. K., Hayward, T., Matthews, R., Dallosso, H. M., Hyde, C., The Leicestershire MRC Incontinence Study Team, (2006). Urinary storage symptoms and comorbidities: a prospective population cohort study in middle-aged and older women. Age Ageing 35: 16-24 [Abstract] [Full Text]  
• Holroyd-Leduc, J. M., Straus, S. E. (2004). Management of Urinary Incontinence in Women: Scientific Review. JAMA 291: 986-995 [Abstract] [Full Text]  
• Rortveit, G., Daltveit, A. K., Hannestad, Y. S., Hunskaar, S., the Norwegian EPINCONT Study, (2003). Urinary Incontinence after Vaginal Delivery or Cesarean Section. NEJM 348: 900-907 [Abstract] [Full Text]  
• Bastian, L. A., Smith, C. M., Nanda, K. (2003). Is This Woman Perimenopausal?. JAMA 289: 895-902 [Abstract] [Full Text]