OBJECTIVE: To estimate the prevalence of and risk factors for stress and urg e incontinence in a biracial sample of well-functioning older women. METHODS: We performed a cross-sectional analysis of 1,584 white and bla...OBJECTIVE: To estimate the prevalence of and risk factors for stress and urg e incontinence in a biracial sample of well-functioning older women. METHODS: We performed a cross-sectional analysis of 1,584 white and blade women, aged 70-7 9 years, enrolled in a longitudinal cohort study. Participants were asked about incontinence, medical problems, and demographic and reproductive characteristics and underwent physical measurements. Using multivariable logistic regression, w e compared women reporting at least weekly incontinence with those without incon tinence. RESULTS: Overall, 21%reported incontinence at least weekly. Of these, 42%reported predominantly urge incontinence, and 40%reported stress. Nearly tw ice as many white women as black women reported weekly incontinence (27%versus 14%, P <.001). Factors associated with urge incontinence included white race (o dds ratio [OR] 3.1, 95%confidence interval [CI] 2.0 -4.8), diabetes treated wi th insulin (OR 3.5, 95%CI 1.6-7.9), depressive symptoms (OR 2.7, 95%CI 1.4-5 .3), current oral estrogen use (OR 1.7, 95%CI 1.1-2.6), arthritis (OR 1.7, 95 %CI 1.1-2.6), and decreased physical performance (OR 1.6 per point on 0-4 sca le, 95%CI 1.1-2.3). Factors associated with stress incontinence were chronic o bstructive pulmonary disease (OR 5.6, 95%CI 13-23.2), white race (OR 4.1, 95% CI 2.5-6.7), current oral estrogen use (OR 2.0, 95%CI 1.3-3.1), arthritis (OR 1.6, 95%CI 1.0-2.4), and high body mass index (OR 1.3 per 5 kg/m2, 95%CI 1.1 -1.6). CONCLUSION: Urinary incontinence is highly prevalent, even in well-func tioning older women, whites in particular. Many risk factors differ for stress a nd urge incontinence, suggesting differing etiologies and prevention strategies.展开更多
Objective: Gestational weight gain consistent with the Institute of Medicine’s recommendations is associated with better maternal and infant outcomes. The objective was to quantify the effect of pre-pregnancy factors...Objective: Gestational weight gain consistent with the Institute of Medicine’s recommendations is associated with better maternal and infant outcomes. The objective was to quantify the effect of pre-pregnancy factors, pregnancy-related health conditions, and modifiable pregnancy factors on the risks of inadequate and excessive gestational weight gain. Method: A longitudinal cohort of pregnant women (N = 1100) who completed questions about diet and weight gain during pregnancy and delivered a singleton, full-term infant. Results: Gestational weight gain was inadequate for 14%and excessive for 53%. Pre-pregnancy factors contributed 74%to excessive gain, substantially more than pregnancy-related health conditions (15%) and modifiable pregnancy factors (11%). Pre-pregnancy factors, pregnancy-related health conditions, and modifiable pregnancy factors contributed fairly equally to the risk of inadequate gain. Conclusion: Interventions to prevent excessive gestational gain may need to start before pregnancy. Women at risk for inadequate gain would also benefit from interventions directed toward modifiable factors during pregnancy.展开更多
文摘OBJECTIVE: To estimate the prevalence of and risk factors for stress and urg e incontinence in a biracial sample of well-functioning older women. METHODS: We performed a cross-sectional analysis of 1,584 white and blade women, aged 70-7 9 years, enrolled in a longitudinal cohort study. Participants were asked about incontinence, medical problems, and demographic and reproductive characteristics and underwent physical measurements. Using multivariable logistic regression, w e compared women reporting at least weekly incontinence with those without incon tinence. RESULTS: Overall, 21%reported incontinence at least weekly. Of these, 42%reported predominantly urge incontinence, and 40%reported stress. Nearly tw ice as many white women as black women reported weekly incontinence (27%versus 14%, P <.001). Factors associated with urge incontinence included white race (o dds ratio [OR] 3.1, 95%confidence interval [CI] 2.0 -4.8), diabetes treated wi th insulin (OR 3.5, 95%CI 1.6-7.9), depressive symptoms (OR 2.7, 95%CI 1.4-5 .3), current oral estrogen use (OR 1.7, 95%CI 1.1-2.6), arthritis (OR 1.7, 95 %CI 1.1-2.6), and decreased physical performance (OR 1.6 per point on 0-4 sca le, 95%CI 1.1-2.3). Factors associated with stress incontinence were chronic o bstructive pulmonary disease (OR 5.6, 95%CI 13-23.2), white race (OR 4.1, 95% CI 2.5-6.7), current oral estrogen use (OR 2.0, 95%CI 1.3-3.1), arthritis (OR 1.6, 95%CI 1.0-2.4), and high body mass index (OR 1.3 per 5 kg/m2, 95%CI 1.1 -1.6). CONCLUSION: Urinary incontinence is highly prevalent, even in well-func tioning older women, whites in particular. Many risk factors differ for stress a nd urge incontinence, suggesting differing etiologies and prevention strategies.
文摘Objective: Gestational weight gain consistent with the Institute of Medicine’s recommendations is associated with better maternal and infant outcomes. The objective was to quantify the effect of pre-pregnancy factors, pregnancy-related health conditions, and modifiable pregnancy factors on the risks of inadequate and excessive gestational weight gain. Method: A longitudinal cohort of pregnant women (N = 1100) who completed questions about diet and weight gain during pregnancy and delivered a singleton, full-term infant. Results: Gestational weight gain was inadequate for 14%and excessive for 53%. Pre-pregnancy factors contributed 74%to excessive gain, substantially more than pregnancy-related health conditions (15%) and modifiable pregnancy factors (11%). Pre-pregnancy factors, pregnancy-related health conditions, and modifiable pregnancy factors contributed fairly equally to the risk of inadequate gain. Conclusion: Interventions to prevent excessive gestational gain may need to start before pregnancy. Women at risk for inadequate gain would also benefit from interventions directed toward modifiable factors during pregnancy.
