Prevalence and obstetric risk factors of stress urinary incontinence in parous women: a cross-sectional study in rural areas of Mangaluru, India.

BACKGROUND: Stress urinary incontinence (SUI) is common among parous women, yet community-level data from rural India remain limited. This study estimated the prevalence of SUI among relatively healthy, rural, reproductive-age parous women without major comorbidities. METHODS: A community-based cross-sectional study was conducted among 412 parous women (aged 25-40 years) using proportionate stratified random sampling across seven rural wards. SUI was assessed using the modified International Continence Society (ICS) Uniform Cough Stress Test (CST) with a standard bladder-fill protocol. Obstetric data were collected via a validated questionnaire. Bivariate and multivariable associations were analysed using modified Poisson regression with robust standard errors to estimate crude prevalence ratios (cPR) and adjusted prevalence ratios (aPR). RESULTS: The prevalence of SUI was 53.4% (n = 220), yet 98.3% (n = 405) of participants had no prior information regarding its management. The relatively high prevalence may reflect the use of an objective modified ICS-based cough stress test, which can identify previously unreported cases. Maternal age was independently associated with higher SUI prevalence in the adjusted modified Poisson regression model (aPR = 1.198 per year; 95% CI [1.168-1.229]; p < 0.001). CONCLUSION: SUI affects more than half of relatively healthy, reproductive-age parous women in this rural setting; however, these findings represent associations within a clinically screened population and should not be interpreted as causal relationships or generalised to all rural women. Increasing maternal age was independently associated with higher SUI prevalence, supporting consideration of routine pelvic floor assessment and targeted community-based education within primary maternal healthcare services.