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Post-pregnancy weight loss linked to incontinence risk

It may not be how much weight a woman gains during pregnancy, but how much she loses afterward, that affects her risk of urinary incontinence after childbirth.

Post-pregnancy weight loss linked to incontinence risk

It may not be how much weight a woman gains during pregnancy, but how much she loses afterward, that affects her risk of urinary incontinence after childbirth.

A number of studies have shown that excess weight, particularly around the abdomen, is associated with an elevated risk of urinary incontinence in women. In addition, weight loss in overweight and obese women has been found to curb their risk of incontinence. Urinary incontinence is also related to pregnancy itself. Many women have problems with urine leakage during pregnancy, and pregnancy - particularly with vaginal delivery - is a risk factor for developing urinary incontinence at some point in a woman's life. However, it has not been clear whether the amount of weight a woman gains during pregnancy affects her risk of urinary incontinence either before or after childbirth.

To look if weight gain during pregnancy may contribute to urinary incontinence during and after pregnancy, researchers followed nearly 12,679 Norwegian women during a first-time pregnancy. The participants completed questionnaires during their 15th and 30th weeks of pregnancy and six months after giving birth. Overall, 40 percent reported urinary incontinence during the 30th week of pregnancy; 21 percent reported a new problem with urine leakage six months after giving birth.

Women who reported gaining a relatively high amount of weight in the first 15 weeks of pregnancy (about 7 kg or more) did have a somewhat higher risk of incontinence by the 30th week. Forty-five percent reported the problem, versus 38 percent of women who had gained roughly 3 kg or less. However, weight gain after the 15th week was not related to the risk of urinary incontinence by the 30th week. And there was no relationship between weight gain during pregnancy and the odds of incontinence six months after childbirth. In contrast, it was found, among women who had incontinence during pregnancy, the odds of still having the problem six months after delivery dipped by two percent for every two pounds she lost after giving birth. Similarly, among women who were continent during pregnancy, those who lost at least 14 kg from delivery onward were less likely to develop urinary incontinence after giving birth. Of those women, 18 percent to 19 percent developed incontinence within six months, versus 23 percent of women who lost fewer pregnancy pounds.

Exactly why weight changes after pregnancy, but not during, were related to incontinence risk is not clear. One possibility, the researchers speculate, is that the type of weight gain that matters. For non-pregnant women, body fat is the main contributor to weight gain; during pregnancy, much of the excess weight is due to the fetus, placenta and increased body fluids.
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