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Body mass index, abdominal fatness, weight gain and the risk of urinary incontinence: a systematic review and dose–response meta‐analysis of prospective studies
Author(s) -
Aune D,
MahamatSaleh Y,
Norat T,
Riboli E
Publication year - 2019
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.15897
Subject(s) - medicine , prospective cohort study , body mass index , meta analysis , relative risk , urinary incontinence , population , confidence interval , cohort study , waist , weight gain , gynecology , urology , body weight , environmental health
Background Adiposity has been associated with elevated risk of urinary incontinence in epidemiological studies; however, the strength of the association has differed between studies. Objectives To conduct a systematic literature review and dose–response meta‐analysis of prospective studies on adiposity and risk of urinary incontinence. Search strategy We searched PubMed and Embase databases up to 19 July 2017. Selection criteria Prospective cohort studies were included. Data collection and analysis Data were extracted by one reviewer and checked for accuracy by a second reviewer. Summary relative risks ( RR s) and 95% confidence intervals ( CI s) were calculated using random effects models. Main results Twenty‐four prospective studies were included. The summary RR per 5 kg/m 2 increment in body mass index (BMI) was 1.20 (95% CI 1.16–1.25, I 2 = 62%, n = 11) for population‐based studies and 1.19 (95% CI 1.08–1.30, I 2 = 87.1%, n = 8) for pregnancy‐based studies, 1.18 (95% CI 1.14–1.22, I 2 = 0%, n = 2) per 10 cm increase in waist circumference and 1.34 (95% CI 1.11–1.62, I 2 = 90%, n = 2) per 10 kg of weight gain. Although the test for nonlinearity was significant for BMI , P = 0.04, the association was approximately linear. For subtypes of urinary incontinence the summary RR per 5 BMI units was 1.45 (95% CI 1.25–1.68, I 2 = 85%, n = 3) for frequent incontinence, 1.52 (95% CI 1.37–1.68, I 2 = 34%, n = 4) for severe incontinence, 1.33 (95% CI 1.26–1.41, I 2 = 0%, n = 8) for stress incontinence, 1.26 (95% CI 1.14–1.40, I 2 = 70%, n = 7) for urge incontinence, and 1.52 (95% CI 1.36–1.69, I 2 = 0%, n = 3) for mixed incontinence. Conclusion These results suggest excess weight may increase risk of urinary incontinence. Tweetable abstract Overweight and obesity increase the risk of urinary incontinence.