{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:55:45Z","timestamp":1791327345391,"version":"4.3.1"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2012,7,25]],"date-time":"2012-07-25T00:00:00Z","timestamp":1343174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:p><jats:italic>Please cite this paper as:<\/jats:italic> Gartland D, Donath S, MacArthur C, Brown S. The onset, recurrence and associated obstetric risk factors for urinary incontinence in the first 18\u2003months after a first birth: an Australian nulliparous cohort study. BJOG 2012;119:1361\u20131369.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold> To investigate the contribution of obstetric risk factors to persistent urinary incontinence (UI) between 4 and 18\u2003months postpartum.<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Prospective pregnancy cohort.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> Six metropolitan public hospitals in Victoria, Australia.<\/jats:p><jats:p><jats:bold>Sample\u2002<\/jats:bold> A total of 1507 nulliparous women recruited to the Maternal Health Study in early pregnancy (\u226424\u2003weeks of gestation).<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Data from hospital records and self\u2010administered questionnaires\/telephone interviews at \u226424 and 30\u201332\u2003weeks of gestation and at 3, 6, 9, 12 and 18\u2003months postpartum analysed using logistic regression.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2002<\/jats:bold> Persistent UI 4\u201318\u2003months postpartum in women continent before pregnancy.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Of the women who were continent before pregnancy, 44% reported UI 4\u201318\u2003months postpartum, and 25% reported persistent UI (symptoms at multiple follow ups). Compared with spontaneous vaginal birth, women who had a caesarean before labour (adjusted odds ratio [aOR] 0.4, 95% confidence interval [95% CI] 0.2\u20130.9), in first\u2010stage labour (aOR 0.4, 95% CI 0.2\u20130.6) or in second\u2010stage labour (aOR 0.4, 95% CI 0.2\u20131.0) were less likely to report persistent UI 4\u201318\u2003months postpartum. Prolonged second\u2010stage labour in women who had an operative vaginal birth was associated with increased likelihood of UI (aOR 2.5, 95% CI 1.3\u20134.6). Compared with women who were continent in pregnancy, women reporting UI in pregnancy had a seven\u2010fold increase in odds of persistent UI (aOR 7.4, 95% CI 5.1\u201310.7).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Persistent UI is common after childbirth and is more likely following prolonged labour in combination with operative vaginal birth. The majority of women reporting persistent UI at 4\u201318\u2003months postpartum also experienced symptoms in pregnancy.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2012.03437.x","type":"journal-article","created":{"date-parts":[[2012,7,25]],"date-time":"2012-07-25T08:44:29Z","timestamp":1343205869000},"page":"1361-1369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["The onset, recurrence and associated obstetric risk factors for urinary incontinence in the first 18\u2003months after a first birth: an Australian nulliparous cohort study"],"prefix":"10.1111","volume":"119","author":[{"given":"D","family":"Gartland","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Donath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"MacArthur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SJ","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,7,25]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2007.01976.x"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2005.09.005"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2007.08.020"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00840.x"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-4-4"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.02928.x"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.obstetgynecol.2003.09.013"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.02107.x"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00818.x"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.02964.x"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1998.tb10045.x"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00721.x"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-6-12"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/1520-6777(2000)19:5<595::AID-NAU6>3.0.CO;2-Q"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-6777(2000)19:2<137::AID-NAU4>3.0.CO;2-G"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.47.6.497"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7294.1096"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(02)02243-4"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-536X.2008.00256.x"},{"key":"e_1_2_10_21_2","volume-title":"Operative Vaginal Delivery: Use of Forceps and Vacuum Extractors for Operative Vaginal Delivery","author":"American College of Obstetricians and Gynecologists","year":"2000"},{"key":"e_1_2_10_22_2","volume-title":"Vaginal Delivery","author":"Royal College of Obstetricians and Gynaecologists","year":"2000"},{"key":"e_1_2_10_23_2","volume-title":"Stata Statistical Software. 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