Age- and type-dependent effects of parity on urinary incontinence: The Norwegian EPINCONT study
Age- and type-dependent effects of parity on urinary incontinence: The Norwegian EPINCONT study
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DOI：
10.1016/s0029-7844(01)01566-6
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发表时间：
2001-12-01
影响因子：
7.2
通讯作者：
Hunskaar, S
中科院分区：
文献类型：
--
作者：
Rortveit, G;Hannestad, YS;Hunskaar, S
目的：调查产次和尿失禁之间的关联，包括尿失禁的亚型和严重程度，在一个随机抽样，特别强调年龄作为一个混杂因素或效果modifier.Methods：这是一个横断面研究（响应率80%）与27,900名参与妇女。通过问卷调查记录产次和尿漏、类型、频率、数量和尿失禁的影响。使用了经验证的严重度指数。相对危险度（RR）与未经产的妇女作为参考被用作effectmeasure.Results：Incidence是由25%的参与者报告。未经产妇女的患病率为8%至32%，随年龄增长而增加。产次与尿失禁相关，第一次分娩最为显著。在20-34岁年龄组中，这种关联最强，初产妇的RR为2.2（95%置信区间[CI] 1.8，2.6），大产妇为3.3（2.4，4.4）。在35-64岁年龄组中发现了较弱的关联（RR在1.4和2.0之间），而在65岁以上的妇女中没有发现关联。对于20-34岁年龄组的压力性尿失禁，初产妇的RR为2.7（2.0，3.5），经产妇为4.0（2.5，6.4）。混合性尿失禁也与产次有关，但与急迫性尿失禁无关。严重程度没有临床显着相关parity.Conclusion：奇偶性是一个重要的危险因素，女性尿失禁在生育和绝经后早期年龄。只有压力性和混合型尿失禁与产次有关。在老年人中，均等的所有影响似乎都消失了。（妇产科2001;98：1004-10。(C)2001年由美国妇产科医师学会出版）。
Objective: To investigate the association between parity and urinary incontinence, including subtypes and severity of incontinence, in an unselected sample, with special emphasis on age as a confounder or effect modifier.Methods: This was a cross-sectional study (response rate 80%) with 27,900 participating women. Data on parity and urinary leakage, type, frequency, amount, and impact of incontinence were recorded by means of a questionnaire. A validated severity index was used. Relative risks (RR) with nulliparous women as reference were used as an effect measure.Results: Incontinence was reported by 25% of participants. Prevalences among nulliparous women ranged from 8% to 32%, increasing with age. Parity was associated with incontinence, and the first delivery was the most significant. The association was strongest in the age group 20-34 years with RR 2.2 (95% confidence interval [CI] 1.8, 2.6) for primiparous women and 3.3 (2.4, 4.4) for grand multiparous women. A weaker association was found in the age group 35-64 years (RRs between 1.4 and 2.0), whereas no association was found among women over 65 years. For stress incontinence in the age group 20-34 years, the RR was 2.7 (2.0, 3.5) for primiparous women and 4.0 (2.5, 6.4) for grand multiparous women. There was an association with parity also for mixed incontinence, but not for urge incontinence. Severity was not clinically significantly associated with parity.Conclusion: Parity is an important risk factor for female urinary incontinence in fertile and peri- and early postmenopausal ages. Only stress and mixed types of incontinence are associated with parity. All effects of parity seem to disappear in older age. (Obstet Gynecol 2001;98: 1004-10. (C) 2001 by the American College of Obstetricians and Gynecologists.).