Is urinary incontinence common during the first trimester of pregnancy?

Urinary Incontinence in First Trimester of Pregnancy

Yes, urinary incontinence is common during the first trimester of pregnancy, affecting approximately 30-40% of pregnant women. The prevalence increases as pregnancy progresses, with higher rates observed in the third trimester.

Prevalence and Types of Urinary Incontinence in First Trimester

• The prevalence of any urinary leakage during the first trimester ranges from 19% to 34.8%, with clinically significant urinary incontinence (leaking at least once per month) affecting 7.2-18% of women 1, 2
• In a recent 2024 study, the prevalence of urinary incontinence was found to be as high as 73.2% in the first trimester 3
• Stress urinary incontinence (SUI) is the most common type during pregnancy (37-78%), followed by mixed urinary incontinence (MUI) and urge urinary incontinence (UUI) 2, 4
• Among women with first-trimester incontinence, most (100% in one study) report leaking only small amounts of urine 2

Risk Factors for Urinary Incontinence in Pregnancy

Several factors increase the risk of developing urinary incontinence during early pregnancy:

• Age: Women ≥35 years have 2.8 times higher risk of developing urinary incontinence during pregnancy 1
• Pre-pregnancy BMI: Overweight (BMI 25-29.99 kg/m²) and obese (BMI ≥30 kg/m²) women have 2-4 times higher risk 1, 4
• Previous urinary tract infections: Associated with 3.8 times increased risk of urinary incontinence during pregnancy 4
• Constipation: Associated with 3.1 times increased risk 4
• Pre-pregnancy urinary leakage: Women who leaked urine less than once per month before pregnancy have 2.6 times higher risk of developing clinically significant UI during pregnancy 1
• Childhood enuresis: Associated with 2.9 times higher risk of pre-pregnancy UI, which can continue into pregnancy 1

Physiological Mechanisms

Urinary incontinence during the first trimester occurs due to several pregnancy-related changes:

• Hormonal changes (increased progesterone, decreased relaxin) affect pelvic floor muscle strength and urethral sphincter function 5
• Decreased collagen levels reduce supportive function of pelvic floor muscles 5
• Even in early pregnancy, increased pressure on the bladder from the growing uterus contributes to incontinence 5
• Increased urinary frequency affects 41.25% of pregnant women, often accompanying incontinence 2

Impact on Quality of Life

• Urinary incontinence can affect approximately 54.3% of pregnant women's quality of life across multiple domains including physical activity, travel, social relationships, and emotional health 5
• Despite its prevalence, urinary incontinence is rarely discussed during prenatal consultations, with only 3.2% of affected women consulting a doctor about this condition 3

Management Considerations

• Most pregnant women are unaware of pelvic floor muscles (only 13.4% knew they had pelvic floor muscles in one study) and their rehabilitation options 3
• Only 8.7% of women with urinary incontinence in pregnancy had benefited from pelvic floor exercises 3
• Pelvic floor muscle exercises can be used as a preventive strategy to reduce stress urinary incontinence in pregnant women 5

Urinary incontinence in the first trimester is a common but often overlooked condition that can significantly impact a woman's quality of life during pregnancy. Healthcare providers should routinely inquire about urinary symptoms during prenatal visits and provide appropriate education and management options.