Relationship between Mode of Delivery and Development of Urinary Incontinence : A Possible Link Is Demonstrated (original) (raw)
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BJOG An International Journal of Obstetrics & Gynaecology
To study the effect of one vaginal delivery (VD) compared with one caesarean section (CS) on the prevalence, severity and bothersomeness of urinary incontinence (UI) subtypes-stress (SUI), urge (UUI) and mixed (MUI)-20 years after delivery. Registry-based national cohort study. Women who returned postal questionnaires (response rate 65.2%) in 2008. Primiparae with one birth in 1985-88 (n = 5236) and no further births. Medical Birth Register data were linked to a questionnaire. Analysis of variance and multivariate analysis were used to obtain adjusted prevalences and odds ratios (adjOR). Prevalence, risk factors, severity, bothersomeness of UI subtypes. The prevalence of SUI, UUI and MUI was 15.3, 6.1, 14.4%, respectively, and was higher for all subtypes after VD versus CS. Moderate to severe incontinence was more prevalent after VD (21.3%) compared with CS (13.5%; adjOR 1.68, 95% confidence interval [95% CI] 1.40-2.03). Bothersome incontinence differed between MUI (38.9%), UUI (27....
Mode of delivery: Urinary incontinence and sexual dysfunction
Background: Sexuality can be embarrassing for many people to discuss. The same goes for incontinence. So it can be doubly difficult to address when incontinence gets in the way of a satisfying sex life. This study is to find the relation between the mode of delivery and incontinence, and evaluating sexual dysfunction as a problem of incontinence. Patients and methods: This study was performed on 300 cases in the department of Obstetrics and Gynecology at Sohag teaching hospital from December 2012 to August 2013.The women were classified into 2 groups , ( group 1 = 150 women ) have previous normal vaginal and(Group 2= 150 women) have previous caesarean section. The presence of urinary incontence and sexual dysfunction was evaluated in both groups. Conclusion: The results of this study have led us to conclude that the risk of urinary incontinence is higher among women who have had vaginal deliveries than among women who have had cesarean sections. The incidence of reporting sexual dysfunction as a problem with urinary incontinence is higher in women with vaginal delivery. Keywords: urinary incontinence, mode of delivery, sexual dysfunctions, problem.
Effect of mode of delivery and parities on the occurrence of urinary incontinence during pregnancy
Fisioterapia em Movimento, 2015
Introduction The urinary incontinence (UI) is a common pathology among women. In the gestation period, it is even more predominant, affecting between 20% and 67%. Objective To evaluate the relation between modes of delivery and parity on the occurrence of urinary incontinence during pregnancy. Methodology 80 pregnant and postpartum women, treated at the Hospital da Mulher, in Campo Grande, MS, Brazil, were selected during September and October 2011, following the inclusion and exclusion criteria of the research. The evaluation protocol consisted of a questionnaire on the clinical history of the patients, gynecological complications, urogynecologic and obstetric information. Results For independent samples, the comparison between the main values observed for the UI was given by the Mann-Whitney test and correlations between urinary incontinence and other variables were given by the Spearman's rank correlation coefficient. The studied group consisted of 40 (50%) primiparous and 40...
BJOG An International Journal of Obstetrics & Gynaecology
Please cite this paper as: Gyhagen M, Bullarbo M, Nielsen T, Milsom I. The prevalence of urinary incontinence 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG 2012; DOI: 10.1111/j.1471-0528.2012.03301.x. Objective To investigate the prevalence and risk factors for urinary incontinence (UI) 20 years after one vaginal delivery or one caesarean section. Design Registry-based national cohort study. Setting Women who returned postal questionnaires (response rate 65.2%) in 2008. Population Singleton primiparae who delivered in the period 1985-1988 with no further births (n = 5236). Methods The Swedish Pregnancy, Obesity and Pelvic Floor (SWEPOP) study linked Medical Birth Register (MBR) data to a questionnaire about UI. Main outcome measures Prevalence of UI and UI for more than 10 years (UI > 10 years) were assessed 20 years after childbirth. Results The prevalence of UI (40.3 versus 28.8%; OR 1.67; 95% CI 1.45...
Persistent urinary incontinence and delivery mode history: a six-year longitudinal study
BJOG: An International Journal of Obstetrics and Gynaecology, 2006
Objective To investigate the prevalence of persistent and long term postpartum urinary incontinence and associations with mode of first and subsequent delivery. Design Longitudinal study. Setting Maternity units in Aberdeen (Scotland), Birmingham (England) and Dunedin (New Zealand). Population Women (4214) who returned postal questionnaires three months and six years after the index birth. Methods Symptom data were obtained from both questionnaires and obstetric data from case-notes for the index birth and the second questionnaire for subsequent births. Logistic regression investigated the independent effects of mode of first delivery and delivery mode history. Main outcome measures Urinary incontinence-persistent (at three months and six years after index birth) and long term (at six years after index birth). Results The prevalence of persistent urinary incontinence was 24%. Delivering exclusively by caesarean section was associated with both less persistent (OR = 0.46, 95% CI 0.32-0.68) and long term urinary incontinence (OR = 0.50, 95% CI 0.40-0.63). Caesarean section birth in addition to vaginal delivery, however, was not associated with significantly less persistent incontinence (OR 0.93, 95% CI 0.67-1.29). There were no significant associations between persistent or long term urinary incontinence and forceps or vacuum extraction delivery. Other significantly associated factors were increasing number of births and older maternal age. Conclusions The risk of persistent and long term urinary incontinence is significantly lower following caesarean section deliveries but not if there is another vaginal birth. Even when delivering exclusively by caesarean section, the prevalence of persistent symptoms (14%) is still high.
International Journal of Women's Health and Reproduction Sciences, 2014
Objectives: This is a cohort study that investigated the incidence, severity and risk factors of Urinary Incontinence during pregnancy and postpartum in nulliparous women. Materials and Methods: In this cohort study, 441 nulliparous women were studied. The women were followed up from the beginning of pregnancy until the postpartum period. The prevalence of urinary incontinence was determined among them. Risk factors that could play a significant role were analyzed using questionnaires. Results: In this study, 441 nulliparous women with an average age of 28.1 ± 3.7 years were studied. The prevalence of urinary incontinence in the third trimester of pregnancy was 39.4% and it was 31% in the postpartum period. Vaginal delivery, maternal weight, and fetal weight (> 4 kg) were the most important risk factors for increasing the incidence rate of urinary incontinence. In this study, age had no role in incontinence. The severity of incontinence in 26.6% of the participants over 5 was based on visual analogue scale (VAS) scoring. Conclusion: Urinary incontinence is one of the common disorders during pregnancy and postpartum period that can affect quality of women life significantly. Type of delivery and maternal and fetal weights are the most important risk factors for increasing this disorder. Unlike previous studies, age did not play any role in incontinency in this study.
Introduction: Although urinary incontinence is commonly associated with increasing parity, there is however a lack of published data on urinary incontinence among primiparous women. This study aims to determine its prevalence among primiparous women at 6-8 weeks postpartum, its risk factors and effects to their quality of life. Methods: This is a crosssectional study involving primiparous women at 6-8 weeks postpartum. Women in their third trimester were recruited using convenience sampling. Data were obtained using a study proforma, and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) over a face-to-face interview. The same questionnaire with additional enquiries on delivery was completed over a telephone interview at 6-8 week postpartum. Data were analysed using chi-square and simple logistic regression tests contained in the Statistical Package for Social Science version 20.0. Results: Three hundred and six women participated in this study. The prevalence of urinary incontinence in the third trimester of pregnancy was 34.3% (95%CI: 29.0, 39.7) and dropped to 5.2% (95% CI: 2.7, 7.7) at 6-8 weeks postpartum. Childhood enuresis and postpartum body mass index were the two factors that showed significant association with postpartum urinary incontinence. Urinary incontinence in 95 (31%) women had resolved by 6-8 weeks postpartum, whereas 10 (3.3%) women still had persistent symptom. A small proportion of women (2.0%) developed urinary incontinence in the postpartum period. Majority of women with urinary incontinence did not feel it significantly affected their quality of life. The ICIQ-SF mean score was 6.13 (range 2-12). Conclusions: Postpartum urinary incontinence is rather uncommon among primiparous women and does not seem to affect their quality of life. Childhood enuresis and postpartum BMI were risk factors associated with postpartum urinary incontinence.
Vaginal delivery parameters and urinary incontinence: The Norwegian EPINCONT study☆
American Journal of Obstetrics and Gynecology, 2003
The study was undertaken to investigate the effect of nine delivery parameters on urinary incontinence in later life. STUDY DESIGN: Incontinence data from the EPINCONT study were linked to the Medical Birth Registry of Norway. Effects of birth weight, gestational age, head circumference, breech delivery, injuries in the delivery channel, functional delivery disorders, forceps delivery, vacuum delivery, and epidural anesthesia were investigated. The study covered women younger than 65 years, who had had vaginal deliveries only (n = 11,397). RESULTS: Statistically significant associations were observed between any incontinence and birth weight 4000 g or greater (odds ratio [OR] 1.1, 95% CI 1.0-1.2); moderate or severe incontinence and functional delivery disorders (OR 1.3, 95% CI 1.1-1.6); stress incontinence and high birth weight (OR 1.2, 95% CI 1.1-1.3) and epidural anesthesia (OR 1.2, 95% CI 1.0-1.5); and urge incontinence and head circumference 38 cm or larger (OR 1.8, 95% CI 1.0-3.3). CONCLUSION: The effects were too weak to explain a substantial part of the association between vaginal delivery and urinary incontinence, and statistically significant results may have incurred by chance. (Am J Obstet
BJOG: An International Journal of Obstetrics & Gynaecology, 2009
Objective The objectives of this study were to investigate prevalence of urinary incontinence at 6 months postpartum and to study how continence status during pregnancy and mode of delivery influence urinary incontinence at 6 months postpartum in primiparous women. Design Cohort study. Setting Pregnant women attending routine ultrasound examination were recruited to the Norwegian Mother and Child Cohort Study (MoBa). Population A total of 12 679 primigravidas who were continent before pregnancy. Methods Data are from MoBa, conducted by the Norwegian Institute of Public Health. Data are based on questionnaires answered at week 15 and 30 of pregnancy and 6 months postpartum. Main outcome measures Urinary incontinence 6 months postpartum is presented as proportions, odds ratios and relative risks (RRs). Results Urinary incontinence was reported by 31% of the women 6 months after delivery. Compared with women who were continent during pregnancy, incontinence was more prevalent 6 months after delivery among women who experienced incontinence during pregnancy (adjusted RR 2.3, 95% CI 2.2-2.4). Adjusted RR for incontinence after spontaneous vaginal delivery compared with elective caesarean section was 3.2 (95% CI 2.2-4.7) among women who were continent and 2.9 (95% CI 2.3-3.4) among women who were incontinent in pregnancy. Conclusion Urinary incontinence was prevalent 6 months postpartum. The association between incontinence postpartum and mode of delivery was not substantially influenced by incontinence status in pregnancy. Prediction of a group with high risk of incontinence according to mode of delivery cannot be based on continence status in pregnancy.