The risk of stress incontinence 5 years after first delivery

OBJECTIVES: We aimed to evaluate the impact of a first pregnancy and delivery on the prevalence of stress incontinence 5 years afterward. STUDY DESIGN: This longitudinal cohort study included 278 women who were questioned after their first delivery and again 5 years later. RESULTS: The prevalence of stress incontinence 5 years after a first delivery was 30%, and the 5-year incidence was 19%. The risk of stress incontinence 5 years after a first delivery was related to the onset and duration of symptoms after the first pregnancy and delivery in a "dose-response-like" manner. The use of vacuum extraction or episiotomy during the first delivery increased the risk. CONCLUSIONS: First pregnancy and delivery may result in stress incontinence 5 years later. Women with incontinence 3 months after a first delivery have a particularly high risk of long-lasting symptoms. Obstetric risk factors are vacuum extraction and episiotomy.     

Fecal incontinence after high-risk delivery

OBJECTIVE: To investigate the prevalence of and factors associated with fecal incontinence and its precursors among high-risk women at 12 months postpartum. METHODS: A survey of women in the immediate and later postpartum was conducted. Participants were 568 women at higher risk of anal sphincter damage, namely those who had an instrumental delivery and/or delivered a high birth weight infant (4000 g or more) at tertiary teaching hospitals in Australia. Women participated in a baseline hospital-based interview and a 12-month follow-up telephone interview. The main outcome measures were frank fecal incontinence (solid and/or liquid stool) and precursor symptoms (flatal incontinence, soiling, and/or fecal urgency) at 12 months postpartum. RESULTS: Prevalence rates were 2.6% for solid stool incontinence and 4.9% for liquid stool incontinence. Overall, 6.9% women had either one or both of these symptoms of frank fecal incontinence. Prevalence rates were 24.4% for flatal incontinence, 10.9% for soiling, and 14.8% for fecal urgency. Overall, 32.4% women had at least one of these precurser symptoms. Concurrent urinary incontinence and postpartum constipation were significantly associated with both frank fecal incontinence and precursor symptoms. In addition, joint hypermobility and older maternal age were associated with frank fecal incontinence, whereas inability to stop the urine flow and multiparity was associated with precursor symptoms. CONCLUSION: The present findings suggest that older and multiparous women, and women with joint hypermobility are at increased risk of postpartum anal incontinence symptoms after a high-risk delivery. Concurrent urinary incontinence, flow-stopping inability, and constipation are also associated with postpartum anal incontinence symptoms after high-risk deliveries.     

Urinary incontinence: is cesarean delivery protective?

About half of all women develop transient urinary incontinence during pregnancy. Three months postpartum, the prevalence and incidence rates of urinary incontinence are 9% to 31% and 7% to 15%, respectively. Antenatal incontinence increases the risk of postpartum incontinence, which in turn increases the risk of long-term persistent incontinence. After the first delivery, women delivered vaginally have two-fold more incontinence than those delivered by cesarean. The protective effect of cesarean on urinary incontinence may dissipate after further deliveries, decreases with age, and is not present in older women. Data are mixed about whether cesarean done before labor confers greater protection than cesarean done after labor. To understand the true impact of cesarean delivery on urinary incontinence, future studies must compare incontinence by planned (not actual) delivery modes, consider a woman's entire reproductive career, focus on leakage severe enough to be problematic, consider other bladder symptoms as well as incontinence, and take into account other risk factors, particularly antepartum urinary incontinence.     

Stress urinary incontinence 4 years after the first delivery: a retrospective cohort survey

BACKGROUND: Our aim was to estimate the prevalence of stress urinary incontinence 4 years after the first delivery and analyze its risk factors. METHODS: A retrospective cohort survey was conducted in a French university hospital. The 669 primiparous women who delivered in our department in 1996 a singleton in a vertex position between 37 and 41 weeks of amenorrhea were included. A mailed questionnaire was sent 4 years after the indexed delivery. The main outcome measure was stress urinary incontinence 4 years after the first delivery. RESULTS: Three hundred and seven women replied, 274 had moved and 88 did not respond. Four years after the first delivery, prevalence of stress urinary incontinence was 29% (89/307). According to multiple logistic regression analysis, the independent risk factors were urine leakage before the first pregnancy [odds ratio (OR) 18.7; 95% confidence interval (CI) 3.6-96.4], urine leakage during the first pregnancy (OR 2.5; 95% CI 1.3-4.8), duration of first labor > or = 8 h (OR 3.1; 95% CI 1.7-5.7), mother's age > 30 years at the first delivery (OR 2.4; 95% CI 1.4-4.2) and cesarean section at the first delivery (OR 0.3; 95% CI 0.1-0.9). CONCLUSION: Our results suggest that stress urinary incontinence after pregnancy arises from a multifactorial condition. The main risk factors are: age, previous incontinence (before or during the first pregnancy), prolonged labor and vaginal delivery.     

Urinary and anal incontinence in African American teenaged gravidas during pregnancy and the puerperium

STUDY OBJECTIVE: To determine the prevalence of urinary and anal incontinence during pregnancy and immediately postpartum in a convenience sample of African American teenaged women in an urban setting and to assess for an association between this incontinence and obstetrical risk factors. METHODS: 74 African American adolescents, ages 14-19, participated in the study. During third trimester prenatal visits and at 6 weeks postpartum, participants completed the Wexner Continence Grading Scale and Urogenital Distress Inventory Short Form (UDI-6). Chart abstraction was conducted for other relevant history. RESULTS: Seventy-eight percent (58/74) of the adolescents were followed for the duration of the study; 22% were lost to follow-up. Incontinence was defined by a positive response on either questionnaire, irrespective of severity. In the third trimester, 44% of patients complained of urinary urge incontinence and 43% of stress incontinence; 12% complained of fecal and 41% of flatal incontinence. At six weeks postpartum, only 9% complained of urge incontinence and 5% of stress symptoms. Similarly, fecal incontinence decreased to 4% and flatal incontinence to 9%. Postpartum, the rate of flatal incontinence in the women who underwent instrumental deliveries was significantly increased when compared to those who had a spontaneous vaginal delivery or cesarean section (OR 12, P = 0.04). CONCLUSION: Urinary and anal incontinence is present in this convenience sample of pregnant African American teenagers and should be addressed during pregnancy and the puerperium. Instrumental delivery significantly increased the risk of flatal incontinence postpartum in this population.     

分娩方式对产妇盆底支持组织功能的近期影响

目的 探讨不同分娩方式及产科相关因素对盆底支持组织功能的近期影响.方法 选取健康初产妇120例,其中阴道分娩72例(阴道分娩组),选择性剖宫产48例(剖宫产组),于分娩后6至8周间进行尿失禁问卷调查、盆底肌电图测定盆底肌肉收缩及舒张功能,并行相关性分析.结果 阴道分娩组与剖宫产组产妇分娩后SUI的发生率分别为21%(15/72)、10%(5/48).阴道分娩组盆底肌电图右侧活力值、功值分别为12.9±0.8和59±5,左右两侧平均功值为78±5;剖宫产组右侧活力值、功值分别为17.3±1.7和95±17,左右两侧平均功值109±15,两组各项值比较,差异均有统计学意义(P＜0.05).产妇的年龄(P＜0.01)、分娩前体重指数(P＜0.01)、新生儿出生体重(P＜0.01)及第二产程时间(P=0.003)是产后发生SUI的高危因素;年龄、分娩前后体重指数差、第一产程时间、会阴侧切口长度和角度对盆底肌电图的部分测量值有影响.结论 阴道分娩后SUI发生率与选择性剖宫产相似;产科相关因素可以影响产后尿失禁的发生率及盆底肌肉收缩及舒张功能.     

Urinary incontinence in pregnancy and in puerperium: 3 months follow-up after delivery

AIM: The aim of this clinic prospective study was to point out the predisposing risk factors for the development of urinary incontinence during pregnancy and postpartum and to understand how to prevent the symptomatology. METHODS: Sixty seven primipara women at 32 weeks of pregnancy and 3 months after the delivery, were studied through an urogynecological work-up and a questionnaire on the main urinary symptoms. RESULTS: At 32 weeks of pregnancy, 27 patients (40.29%) were affected by stress urinary incontinence (SUI) of type I and 22 (32.83%) by urge incontinence. Three months after delivery, it was observed SUI of type I in 8 patients (15.68%), SUI of type II in 9 patients (17.64%), SUI of type II and II degree cystouretrocele in 3 patients (5.8%) and urge incontinence in 14 patients (27.45%). The most frequent risk factors that were tracked down were: a vaginal delivery, with a prolonged labour, and the episiotomy. We didn't find either substantial changes in the weight between patients continent and incontinent or correlations with the patients' age or with the weight of the foetus and the symptomatology reported. CONCLUSION: It is important to understand the beginning of the urinary symptoms in the pregnant women, to prevent the worsening of it. It is required, however, a long term follow-up on our patients to verify if the urinary incontinence persists or disappears by the time is needed.     

Risk of urinary incontinence after childbirth: a 10-year prospective cohort study

OBJECTIVE: To estimate prospectively the effect of first delivery on subjective bladder function and to assess the influence of subsequent deliveries and obstetric events METHODS: We performed a prospective, observational cohort study. During a 10-week period in 1995, 304 of 309 eligible primiparous women (98%) entered the study at the postpartum maternity ward and completed a bladder function questionnaire. The 10-year observational period was completed by 246 of 304 subjects (81%). RESULTS: Prevalence of moderate-severe stress urinary incontinence increased from 5 of 304 subjects (2%) at baseline to 27 of 229 (12%) at 10 years follow-up (P < .001). Prevalence of moderate-severe urinary urgency increased from 0 subjects (0%) at baseline to 31 of 229 (13%) at the 10-year follow-up (P < .001). The relative risk (RR) (adjusted for maternal age and parity) of moderate to severe urinary incontinence increased significantly 10 years after first delivery (RR 5.8, 95% confidence interval [CI] 1.2-33.7). At multivariable analysis adjusted for age and parity, stress urinary incontinence symptoms at 9 months and 5 years follow-up were independently associated with the presence of symptoms at 10 years after index delivery (RR 13.3, 95% CI 3.9-33.1 and RR 14.1, 95% CI 2.5-18.8, respectively). Number of vaginal deliveries or other obstetric covariates did not affect the risk of stress urinary incontinence or urinary urgency. CONCLUSION: Vaginal delivery is independently associated with a significant long-term increase in stress urinary incontinence symptoms, as well as urinary urgency, regardless of maternal age or number of deliveries. LEVEL OF EVIDENCE: II-2.     

Do fertile women remember the onset of stress incontinence? Recall bias 5 years after 1st delivery

BACKGROUND: To evaluate fertile women's ability to recall the onset of stress incontinence. METHODS: In a prospective cohort study 305 primiparae were interviewed after 1st delivery and again 5 years later using a tested questionnaire. In 83 women with stress incontinence 5 years after 1st delivery history of onset was compared with data from the initial questionnaire by grouping women with onset before 1st pregnancy, during 1st pregnancy, during 1st puerperium or after 1st puerperium. RESULTS: Five years after 1st delivery only 26% recalled the onset of stress incontinence precisely. The statistical agreement for each of the four groups of women with different recall of onset varied with a Kappa from 0.02 to 0.38. CONCLUSION: Five years after 1st delivery stress incontinent women seem to recall the onset of the symptom imprecisely.     

Effects of carrying a pregnancy and of method of delivery on urinary incontinence: a prospective cohort study

BACKGROUND: This study was carried out to identify risk factors associated with urinary incontinence in women three months after giving birth. METHODS: Urinary incontinence before and during pregnancy was assessed at study enrolment early in the third trimester. Incontinence was re-assessed three months postpartum. Logistic regression analysis was used to assess the role of maternal and obstetric factors in causing postpartum urinary incontinence. This prospective cohort study in 949 pregnant women in Quebec, Canada was nested within a randomised controlled trial of prenatal perineal massage. RESULTS: Postpartum urinary incontinence was increased with prepregnancy incontinence (adjusted odds ratio [adj0R] 6.44, 95% CI 4.15, 9.98), incontinence beginning during pregnancy (adjOR 1.93, 95% CI 1.32, 2.83), and higher prepregnancy body mass index (adjOR 1.07/unit of BMI, 95% CI 1.03,1.11). Caesarean section was highly protective (adjOR 0.27, 95% CI 0.14, 0.50). While there was a trend towards increasing incontinence with forceps delivery (adjOR 1.73, 95% CI 0.96, 3.13) this was not statistically significant. The weight of the baby, episiotomy, the length of the second stage of labour, and epidural analgesia were not predictive of urinary incontinence. Nor was prenatal perineal massage, the randomised controlled trial intervention. When the analysis was limited to women having their first vaginal birth, the same risk factors were important, with similar adjusted odds ratios. CONCLUSIONS: Urinary incontinence during pregnancy is extremely common, affecting over half of pregnant women. Urinary incontinence beginning during pregnancy roughly doubles the likelihood of urinary incontinence at 3 months postpartum, regardless whether delivery is vaginal or by Caesarean section.     

Urinary incontinence in pregnancy and prevention of perineal complications of labor

BACKGROUND: Female urinary incontinence often manifests itself for the first time during pregnancy in a great number of women (23-50%). In many cases it is transitory in nature, the result of the stress induced by the pregnancy on the pelvic floor. In this study the authors discuss the frequency of urinary incontinence on the basis of a questionnaire administered to a limited sample group of obstetrics patients in order to identify the potential risk factors and to plan protective and rehabilitative strategies for the pelvic floor both during pregnancy and before and after delivery. METHODS: From November 1998 until June 1999 at the Obstetrics and Gynecology Clinic of the University of L'Aquila (Italy) 150 women were surveyed by written questionnaire both before delivery and on the second day following delivery. Those who were identified as having urinary incontinence during pregnancy were readministered the questionnaire at three months following delivery. RESULTS: Urinary incontinence was reported during pregnancy by 48% of the women under examination, which appeared, for the most part, during the third trimester of the pregnancy (in 43% of the women). No differences related to age were discovered, while a cesarean section played a protective role. For women with preexisting IUS the new pregnancy was an aggravating factor. Of the women with IUS during pregnancy who did not demonstrate preexisting symptoms only 9.4% reported persistent urinary incontinence at three months following delivery. Among women pregnant for the first time with persistent symptoms all had received episiotomies by the third month following delivery. CONCLUSIONS: The authors of this study wish to direct their attention to the identification of women with IUS during pregnancy so that damage from delivery can be reduced to a minimum and rehabilitation strategies for the functioning of the pelvic floor can be imitated as soon as possible.     

From delivery mode to incontinence

Vaginal delivery has been considered to be the main cause of pelvic static disorders since obstetric is taught. Epidemiological studies generally confirm the greater prevalence of urinary or fecal incontinence after delivery. Analysis of available data lead to the following observations. Urge urinary incontinence is not associated with the number of pregnancies or the mode of delivery. At age equivalence, stress urinary incontinence is more frequent among women who delivered by C-section compared with women without children. Also at age equivalence, stress incontinence is more frequent in women who delivered by the vaginal route compared with those who had C-section. This difference disappears with age, while stress urinary incontinence during pregnancy is a risk factor 15 days later. The only published randomized trial demonstrated a higher prevalence of stress urinary incontinence three months after delivery in the vaginal route group, but this difference disappeared at two years. Fecal incontinence is more frequent after delivery, especially in the event of forceps delivery. Nevertheless late after delivery, the prevalence of fecal incontinence is similar between spontaneous vaginal, forceps, or C-section delivery. The mode of delivery thus has an impact on continence. However, late after delivery, the influence of pregnancy and delivery fades out either due to a process of repair or via the intermediary of other predominant risk factors (age, tissue quality). The beneficial effect of programmed C-section on continence has not been demonstrated.     

分娩方式对尿失禁发生的影响

目的研究不同分娩方式对尿失禁发生及其程度的影响.方法选择2001年3月至2002年3月在北京大学第一医院妇产科分娩的初产妇1000例,采用国际尿失禁咨询委员会提供的尿失禁问卷表对其进行电话访问,了解她们孕前、孕期、产后1年及近期排尿情况.根据病例记录的分娩方式及相关资料,共完成有效病例548例.通过SPSS软件包计算各分娩方式中发生尿失禁的比例和程度,及影响尿失禁发生的相关因素.结果 (1)548例患者中有尿失禁症状者167例(30.5%).(2)对尿失禁发生的相关因素进行logistic回归分析,发现剖宫产及新生儿体重为产后发生尿失禁的影响因素.以阴道顺产发生尿失禁的OR为 1.0计算,剖宫产的OR=0.326,新生儿体重的OR=1.633.在阴道顺产及产钳助产分娩中,仅新生儿体重为发生尿失禁的高危因素(P=0.013,OR=2.081).(3)阴道顺产、产钳助产和剖宫产3者中尿失禁的发生率分别为38.6%(105/272)、43.8%(21/48)和18.0%(41/228),阴道顺产和产钳助产组间尿失禁发生率无显著性差异(P>0.05),两组与剖宫产组尿失禁的发生率比较,差异均有显著性(P<0.05).(4)阴道顺产组中混合性、压力性和急迫性尿失禁的比例分别为 4.4%、33.8%和0.4%.产钳助产组中3种尿失禁的比例分别为 8.3%、35.4%和0.0%.剖宫产组中以上3种尿失禁的比例分别为3.1%、14.5%和0.4%.压力性尿失禁在阴道顺产组和产钳助产组的发生率均高于剖宫产组(P<0.05),且重度压力性尿失禁的例数在阴道顺产组中高于剖宫产组(P<0.05).(5)尿失禁发生的时间167例患者中以产前即有、孕期出现并在产后1年内消失、产后1年内出现并在1年内消失、产后1年内出现并持续1年以上、产后1年以后或近期新出现等5种情况分类,其发生率分别为1.2%(2/167)、7.8%(13/167)、44.9%(75/167)、40.7% (68/167)和2.4%(4/167).结论 (1)与阴道顺产和产钳助产比较,剖宫产可降低压力性尿失禁的发生风险.(2)患者尿失禁的症状主要出现于产后1年内,其中部分患者症状可以持续1年以上.(3)新生儿体重增加使压力性尿失禁发生的风险增加.     

Persistent stress urinary incontinence during pregnancy and one year after delivery; its prevalence,risk factors and impact on quality of life in Taiwanese women: An observational cohort study

Objective

The study was to investigate the prevalence and risk factors of stress urinary incontinence (SUI) and its impact on the quality of life during pregnancy and 12 months after delivery.

Urinary symptoms in pregnancy: are they useful for diagnosis?

This is the second part of a study assessing 161 women 12 weeks after their first delivery. The urodynamic data have previously been published [ Br J Obstet Gynaecol 2000; 107:1354]. The symptoms have been assessed using a (non-validated) urinary symptom questionnaire. There was no correlation between symptoms and urodynamic findings and most importantly between the symptom of stress incontinence, a diagnosis of urodynamic stress incontinence (USI) and vaginal delivery. Symptoms of incontinence and abnormal urodynamic findings were also found in women who underwent caesarean section. These data explain why caesarean section does not appear to be wholly protective in preventing postpartum incontinence. This suggests that the aetiology of postpartum incontinence is multifactorial and urinary symptoms are misleading in determining the underlying causes.     

Obstetric risk factors for stress urinary incontinence: a population-based study

OBJECTIVE: To evaluate obstetric and maternal risk factors for stress urinary incontinence. METHODS: We linked three national, Swedish, population-based registries with the use of unique personal identification numbers. All women born between 1932 and 1977 and operated on for stress urinary incontinence between 1987 and 1996 were identified from the Hospital Discharge Registry. This information was linked with the Medical Birth Registry (for the years 1973-1995), containing information on antenatal care, delivery, and the newborn, and the Fertility Registry (for the years 1932-1997), containing information on the number of children delivered by each Swedish woman. For determination of odds ratios (ORs) and approximate 95% confidence intervals (CIs), we used the Mantel-Haenszel method and a test-based method after suitable stratifications and exclusions. RESULTS: Diabetes mellitus, body mass index (BMI), age at first delivery, parity, birth weight, and epidural analgesia were positively associated with incontinence surgery. In contrast, cesarean delivery, forceps/vacuum extraction, and episiotomy were negatively associated with incontinence surgery. No association was found between surgery for stress incontinence and age at last delivery, smoking during pregnancy, level of education, multiple birth, large perineal tear, or breech presentation at any vaginal delivery. The OR for incontinence surgery was similarly decreased for nulliparous women and for uniparous women delivered by elective cesarean. CONCLUSION: Vaginal delivery, notably the first, is strongly associated with later surgery for stress incontinence, but the association is modified by maternal conditions and interventions during delivery. No association was found between surgery for stress incontinence and pregnancy per se.     

压力性尿失禁初始发病时间分析

目的：对女性压力性尿失禁初始发病时间进行探讨，以便采取预防措施。方法：对我院2000年12月-2003年2月期间就诊的全部408例女性压力性尿失禁病例的初始发病时间做回顾性分析。结果：初始发病在分娩后12个月内者为166例，占40．69％，初始发病在更年期或绝经后2年者为115例，占28．19％。结论：分娩后12个月内及更年期或绝经后2年为患者初始发病比较集中的两个时期，应加强这两个时期的妇女保健。     

Postpartum urinary stress incontinence: analysis of the associated risk factors and neurophysiological tests

AIM: The aim of this paper is to estimate the prevalence of postpartum urinary stress incontinence (USI) three months after vaginal delivery and to analyze the risk factors more frequently correlated with USI. Pelvic floor neurophysiology was performed to assess pudendal nerve damage in symptomatic women. METHODS: A total of 562 women were interviewed and underwent urogynecological evaluation three days after vaginal delivery. They were contacted by telephone 12 weeks later. Chart abstraction was conducted to obtain obstetrical data. Three months after delivery women presenting persistent USI were invited to return for electrophysiological tests. Univariate and logistic regression analyses were performed to reveal any significant association between USI and risk factors. RESULTS: Prevalence of postpartum USI three days after delivery was 15%, decreasing to 10.6% at follow-up three months later. Multivariate analysis of risk factors revealed that persistent USI was significantly associated with: preconception USI (P<0.05), USI developed de novo after delivery (P<0.05), family history of incontinence (P<0.05), chronic cough (P<0.05) and smoking (P<0.05). No obstetric variables were independently connected with incontinence. Neurophysiological tests revealed nerve damage in 36% of the symptomatic puerperae. CONCLUSION: Persistent postpartum incontinence is associated with several maternal and urogynecological risk factors that can help to detect women at risk for early intervention.     

A longitudinal follow up of women in their practice of perinatal pelvic floor exercises and stress urinary incontinence in North-East Scotland

OBJECTIVES: to establish the reported practice of pelvic floor exercises and stress urinary incontinence after delivery. DESIGN: a longitudinal study using a postnatal postal questionnaire. PARTICIPANTS: 257 women in the North-East of Scotland were sent questionnaires between June and December 2000, 6-12 months after delivery (previously recruited and interviewed during the last trimester of pregnancy). One hundred and sixty-three women responded (63.4%). FINDINGS: more women reported the practice of pelvic floor exercises after delivery than during pregnancy: 134 (83.2%) compared with 123 (76.4%). Six to 12 months after delivery, 96 (60%) women said that they were still doing the exercises. A third of respondents (n=54, 33.1%) reported stress incontinence at some time since having the baby. Of those reporting incontinence at the time of questionnaire completion, six (19.3%) said the incontinence was moderate or severe, whereas eight (34.7%) reported incontinence once a week or more. Women who had an operative vaginal delivery (forceps or ventouse delivery) were more likely to report the practice of pelvic floor exercises than those having a spontaneous vaginal delivery. No significant difference was found in reported rates of stress incontinence between women who had different modes of delivery. The practice of pelvic floor exercises daily or more often during pregnancy was associated with less reported postnatal incontinence compared with less frequent practice. KEY CONCLUSIONS: self-reported rates of practice of pelvic floor exercises increased from pregnancy to the immediate postnatal period and subsequently declined. A third of women reported the symptoms of stress incontinence after delivery. Daily or more frequent practice of the exercises during pregnancy may be required in order to prevent postnatal incontinence (although further research is required to confirm this finding). IMPLICATIONS FOR PRACTICE: midwives should continue to encourage regular and frequent practice of pelvic floor exercises in the postnatal period and beyond. They also need to ask about symptoms of stress incontinence and refer as necessary.     

Urinary disorders during pregnancy and postpartum: our experience

The changes that take place in the pelvic region during birth can give rise to alterations in the genitourinary system which are at the basis of pathologies such as stress urinary incontinence (SUI). The occurrence of this condition has been correlated to a variety of factors including neonatal birth weight and obesity. We studied 120 women, 60 nulliparae, 40 primiparae and 20 multiparae who were divided into three groups on the basis of urinary problems experienced. The first group consisted of women who had reported urinary incontinence during pregnancy (76%). This was found to be significantly correlated to the number of pregnancies and weight gained; 18% of this group reported IUS during the postpartum period. The second group consisted of women who did not experience any urinary incontinence during the pregnancy or postpartum while the third group consisted of women who, although not experiencing any urinary problems during pregnancy, reported urinary incontinence in the postpartum period. These data, although only part of an initial study, reveal a consistent frequency of urinary incontinence in pregnancy and postpartum, and highlight risk factors.