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Get Laid Divorce Advice Singlewomenadultservice Single Women Adult Service Obama Hr 1 Single Women Adult Service Prevalence and risk factors of urinary incontinence in Fuzhou Chinese women

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All participants filled out questionnaires by themselves. Health care providers went to participants' homes to retrieve the questionnaires two weeks after distribution. Completely answered questionnaires were actively sought during data collection, to assemble an accurate cross sectional cohort and minimize the likelihood of response bias.

In this study, a woman had urinary incontinence if she replied ‘yes' to the question “Have you had any involuntary urinary loss during the last month?” Stress urinary incontinence (SUI) was defined as involuntary urine leakage when exercising physically. The question about SUI asked in the questionnaire was “Does urine leak when you are physically active, exert yourself, cough or sneeze?” Urge incontinence (UUI) was defined as involuntary urine loss following a sudden urge to void or uncontrollable voiding with little or no warning. The questions about UUI asked in the questionnaire were “Do you have to rush to the toilet to urinate? Does urine leak before you can get to the toilet?” When the respondents acknowledged both symptoms of stress and urge incontinence, the category of mixed incontinence was assigned.

Using these definitions, we then examined characteristics associated with stress incontinence and urge incontinence. Age was considered as a continuous variable in 10 year cohorts, beginning with age 20. Body mass index (BMI) was defined as weight in kilograms divided by square of height in metres. We defined 2 BMI categories: underweight (BMI<75th percentile), overweight (BMI≥75th percentile). A participant was a cigarette smoker if she reported current tobacco use. Women were asked to report their obstetric parity and the route of delivery for each birth. Thus, for each subject, we knew their parity, the number of vaginal births and the number of Caesarean births. For route of delivery, we defined two groups: women who had delivered only by Caesarean section (the Caesarean delivery only group), and women who reported at least one vaginal delivery (the vaginal delivery group). The vaginal delivery group included a small number of women who had also delivered at least one infant by Caesarean delivery. Women in vaginal delivery group were also asked to report if they had had an episiotomy during the second stage of labour.

Chi-square tests were used to compare the prevalence of difference types of symptoms among birth cohorts and to evaluate factors possibly associated with urinary incontinence. Multivariable logistic regression analysis was used to control for possible confounding variables and to determine the independent association between risk factors and urinary incontinence. Variables associated with urinary incontinence (P<0.01) in univariate models were entered into multivariate models. Results are presented as odds ratios with 95% confidence intervals. All analyses were performed using SPSS v11.5 software. A P value of less than 0.05 was considered statistically significant.

RESULTS

Of the 6066 questionnaires mailed, 4745 (78.2%) were returned and 4684 (98.7%) women with complete data were included in this study. There were no differences in age or profession between the population and our sample. The response rates were not significantly different among each of the birth cohorts. All the subjects were of the Han ethnic group, the principal ethnic group (about 93 percent) of the Chinese population.

The characteristics of the study subjects are shown in Table 1 . Their average age was 40.0±11.1 years. Most of the women who had no educational background (128, 13.1%) were older than 60 years. The BMI in this study was 21.9±3.0 kg/m2. The average parity was 1.1±0.8 (0-7) and 398 (8.6%) were nulliparous. There were 709 (15.1%) menopausal women and 877 (18.7%) women were unskilled workers.

The prevalence of three types of urinary incontinence is shown in Table 2 . The overall prevalence of stress incontinence, urge incontinence, and mixed incontinence was 16.6% (n=777), 10.0% (n=468), 7.7% (n=360), respectively. The prevalence of the three types of urinary incontinence in the 20 to 29 year cohort was significantly lower than that of the older age groups. In this cohort, stress incontinence was 8.9% (P<0.05), urge incontinence was 6.9% (P<0.05), mixed incontinence was 4.3% (P<0.05). The prevalence of the three types of urinary incontinence increased significantly with aging (P<0.01). In the 20 to 29 year cohort, there was no significant difference between stress incontinence and urge incontinence (P>0.05). In all other cohorts, the difference was significant between stress incontinence and urge incontinence (P<0.05). The analysis of risk factors of urinary incontinence is shown in Table 3 . The risk factors that might predispose women to stress urinary incontinence and urge incontinence were found after a univariate analysis. Menopause, vaginal delivery, Caesarean dlivery, parity (>2), constipation, alcohol consumption, higher BMI (≥75th percentile), unskilled worker, and a history of diabetes and hypertension were associated with increased occurrence of stress urinary incontinence. Similarly, menopause, vaginal delivery, Caesarean delivery, parity (>2), foetal birthweight, constipation, alcohol consumption, higher BMIs (≥75th percentile), unskilled worker, and a history of diabetes and hypertension were significantly associated with urge incontinence.

The results of a multiple logistic regression analysis are presented in Table 4 . In multiple logistic models, age (OR, 1.3, 95%CI, 1.1-1.4), vaginal delivery (3.0, 1.9-4.7), parity >2 (2.1, 1.5－2.9), hypertension (2.7, 1.4－5.6), constipation (2.6, 1.8-3.8), alcohol consumption (4.7, 1.1－20.2), episiotomy (1.7, 1.4－2.0), higher BMI (1.8, 1.5－2.2), and unskilled worker (0.7, 0.5－0.8) are potential risk factors for stress incontinence. Urge incontinence is associated with age (OR, 1.3, 95%CI, 0.9－1.3), menopause(1.6, 1.1－2.4), Caesarean delivery (0.2, 0.1－0.5), parity >2 (2.6, 1.8－3.8), constipation (2.3, 1.4－3.7), fatal birthweight(1.7, 1.1－2.4), episiotomy(1.4, 1.1－1.8), higher BMI (1.5, 1.2－2.0), and unskilled worker (0.7, 0.5－0.9).

DISCUSSION