Abstract
Purpose
With China’s rapidly aging population and the rising proportion of obese people, an increase in the number of women suffering from urinary incontinence (UI) is to be expected. In order to identify high-risk groups before leakage occurs, we aimed to develop and validate a model to predict the risk of stress UI (SUI) in rural women.
Patients and methods
This study included women aged 20–70 years in rural Fujian who participated in an epidemiologic survey of female UI conducted between June and October 2022. Subsequently the data was randomly divided into training and validation sets in a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to identify independent risk factors as well as to further construct a nomogram for risk prediction. Finally, concordance index (C-index), calibration curve and decision curve analysis were applied to evaluate the performance of the predictive models.
Results
A total of 5290 rural females were enrolled, of whom 771 (14.6%) had SUI. Age, body mass index (BMI), postmenopausal status, number of vaginal deliveries, vaginal delivery of large infant, constipation and family history of pelvic organ prolapse (POP) and SUI were included in the nomogram. C-index of this prediction model for the training and validation sets was 0.835 (95% confidence interval [CI] = 0.818–0.851) and 0.829 (95% CI = 0.796–0.858), respectively, and the calibration curves and decision analysis curves for both the training and validation sets showed that the model was well-calibrated and had a positive net benefit.
Conclusion
This model accurately estimated the SUI risk of rural women in Fujian, which may serve as an effective primary screening tool for the early identification of SUI risk and provide a basis for further implementation of individualized early intervention. Moreover, the model is concise and intuitive, which makes it more operational for rural women with scarce medical resources.
Data Sharing Statement
The data of this study are available from the corresponding author upon reasonable request.
Ethics Approval
Ethical approval was granted by the Ethical Review Committee of Fujian Maternity and Child Health Hospital (2023KYLLR01045)
Acknowledgments
We are grateful for the great support from the Shaxian County government and the grassroots administration at all levels in terms of staff deployment and logistical support. We thank the medical staff of the Shaxian County Basic Health Center for their tremendous efforts, and all the women who participated in the study.
Disclosure
The authors report no conflicts of interest in this work.