Risk factors identification for gynecologic disease

博士 === 國立陽明大學 === 公共衛生研究所 === 100 === Background: The associations between diabetes mellitus and urinary incontinence, and between pregnancy/delivery and urinary incontinence are well established. However, the associations between gestational diabetes mellitus and urinary incontinence have never bee...

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Bibliographic Details
Main Authors: Chi-Mu Chuang, 莊其穆
Other Authors: Pesus Chou
Format: Others
Language:en_US
Published: 2012
Online Access:http://ndltd.ncl.edu.tw/handle/j33qvm
Description
Summary:博士 === 國立陽明大學 === 公共衛生研究所 === 100 === Background: The associations between diabetes mellitus and urinary incontinence, and between pregnancy/delivery and urinary incontinence are well established. However, the associations between gestational diabetes mellitus and urinary incontinence have never been investigated. Methods: A longitudinal cohort study with repeated measure design was conducted by consecutive sampling of pregnant women with term deliveries between January 2002 and December 2007 at a tertiary-care hospital. Results: Full model analysis revealed GDM was an independent risk factor for all type-specific urinary incontinence (odds ratio 95 % confidence interval = 1.97[1.56, 2.51], 3.11[2.18, 4.43], and 2.73[1.70, 4.40] for stress, urge, and mixed incontinence, respectively). Women with GDM tended to exhibit more severe symptoms of stress incontinence for up to 2 years postpartum; while for urge or mixed incontinence, the more severe symptoms only maintained for 6 months postpartum. Evaluation of quality of life (QoL) by IIQ-7 questionnaire, women with GDM requiring insulin treatment had higher likelihood of functional impairment than women with GDM requiring conservative treatment only or women without GDM (P < 0.05, by Chi-square test for trend). Conclusions: Gestational diabetes exerted significant impacts on postpartum urinary incontinence with respect to prevalence and quality of life. Women with gestational diabetes should be provided timely consultation and support once urinary incontinence occurs.