Sampselle Carolyn M, Harlow Siobán D, Skurnick Joan, Brubaker Linda, Bondarenko Irina
School of Nursing, University of Michigan, Ann Arbor 48109, USA.
Obstet Gynecol. 2002 Dec;100(6):1230-8. doi: 10.1016/s0029-7844(02)02241-x.
To document prevalence of mild, moderate, and severe urinary incontinence among ethnically diverse perimenopausal women, identify risk factors, and assess the effect of severity on women's daily lives using treatment seeking, bother, and nighttime voiding as indicators.
Baseline data from the longitudinal cohort of the Study of Women's Health Across the Nation, a prospective, multiethnic, multisite study of the natural history of menopausal transition was used (n = 3302). Interview and self-completed questionnaires assessed most variables of interest. Body mass index and diabetes mellitus were measured clinically. Incontinence severity was derived by multiplying frequency by volume leaked. Risk factors and effect on treatment seeking, bother, and nighttime voiding were assessed by the construction of multiple logistic regression models for each ethnic group and the total population.
Mean age was 46.4 years. Incontinence prevalence was 57%, with nearly 15% categorized as moderate and 10% as severe. Biologic factors constituted the most important risk for severity, specifically perimenopausal compared with premenepausal status (odds ratio [OR] 1.35), body mass index (OR 1.04), diabetes mellitus (OR 1.55), and current smoking (OR 1.38). Nonwhite groups had lower risk, but the relationship of ethnicity is complex. Severity was associated with likelihood of discussing with a health care provider, with bothersomeness, and with likelihood of nighttime voiding.
Large numbers of perimenopausal women experience urinary incontinence with 25% wearing protection or changing undergarments on several days per week. Mutable factors predicting severity included body mass index and current smoking.
记录不同种族围绝经期女性中轻度、中度和重度尿失禁的患病率，识别风险因素，并以寻求治疗、困扰程度和夜间排尿情况为指标，评估严重程度对女性日常生活的影响。
使用全国女性健康研究纵向队列的基线数据，这是一项关于绝经过渡自然史的前瞻性、多民族、多地点研究（n = 3302）。通过访谈和自填问卷评估了大多数感兴趣的变量。临床测量体重指数和糖尿病情况。尿失禁严重程度通过漏尿频率乘以漏尿量得出。通过为每个种族群体和总人口构建多元逻辑回归模型，评估风险因素以及对寻求治疗、困扰程度和夜间排尿的影响。
平均年龄为46.4岁。尿失禁患病率为57%，其中近15%为中度，10%为重度。生物学因素是严重程度的最重要风险因素，特别是围绝经期与绝经前状态相比（优势比[OR] 1.35）、体重指数（OR 1.04）、糖尿病（OR 1.55）和当前吸烟情况（OR 1.38）。非白人组风险较低，但种族关系较为复杂。严重程度与与医疗保健提供者讨论的可能性、困扰程度以及夜间排尿的可能性相关。
大量围绝经期女性存在尿失禁问题，25%的女性每周有几天使用防护用品或更换内衣。预测严重程度的可变因素包括体重指数和当前吸烟情况。
