Abstract
INTRODUCTION AND HYPOTHESIS: This is a prospective cohort study based on the hypothesis that pregnancy and childbirth are associated with the occurrence of bothersome pelvic floor dysfunction (PFD), which impairs health-related quality of life (HRQoL). METHODS: Primiparous women completed a questionnaire including questions about bothersome PFD and HRQoL in early pregnancy, late pregnancy, 8 weeks postpartum, and 12 months postpartum. HRQoL was measured using the Incontinence Impact Questionnaire, Short Form (IIQ-7). The association between bothersome urinary incontinence (UI) 1 year postpartum and maternal and delivery characteristics was examined using generalized linear models. RESULTS: The study sample comprised 851 women. The prevalence of bothersome UI increased from 0.7% in early pregnancy to 8.1% at 1 year postpartum. At 1 year postpartum, 22.8% of the women reported PFD with impairment in HRQoL, with a median IIQ-7 score of 14.3. Bothersome UI in late pregnancy (adjusted RR 4.51, 95% CI 1.43-14.26) and 8 weeks postpartum (adjusted RR 10.17, 95% CI 5.45-18.98) were associated with bothersome UI 1 year postpartum. CONCLUSIONS: Most women were not bothered by UI during pregnancy and up to 1 year postpartum and did not report PFD with impairment in HRQoL. Most women who reported PFD with impairment in HRQoL had low IIQ-7 scores, but a few women reported substantial restriction in lifestyle. Bothersome UI in late pregnancy and 8 weeks postpartum was predictive of bothersome UI 1 year postpartum. This indicates the importance of the early identification of these women to provide appropriate counseling and treatment.