Association of mode of delivery with urinary incontinence and changes in urinary incontinence over the first year postpartum

Obstet Gynecol. 2014 Mar;123(3):568-577. doi: 10.1097/AOG.0000000000000141.

Abstract

Objective: To examine the association between vaginal or cesarean delivery and urinary incontinence (UI) and identify the trend in the change in UI within the first 12 months postpartum.

Methods: This was a prospective longitudinal study of 330 of 749 women who completed a UI questionnaire and a personal characteristics questionnaire over five visits in a medical center.

Results: The vaginal delivery group had a significant higher prevalence of any UI at 4-6 weeks and at 3, 6, and 12 months (29.1-40.2% vaginal compared with 14.2-25.5% cesarean); stress urinary incontinence (SUI) at 4-6 weeks and 3 and 12 months (15.9-25.4% vaginal compared with 6.4-15.6% cesarean); and moderate or severe UI at 3-5 days, 4-6 weeks, and 6 months (7.9-18.5% vaginal compared with 4.3-11.3% cesarean); and a significant higher score for interference in daily life at 3-5 days and 4-6 weeks (1.0, 0.7 vaginal compared with 0.7, 0.4 cesarean) compared with those in the cesarean delivery group. Prevalence increased for any UI, SUI, and slight UI (all P<.02) and daily life interference score decreased (P=.02) for women who had a vaginal delivery through 1 year postpartum.

Conclusion: Vaginal delivery was associated with higher UI prevalence that persisted for 1 year postpartum, but there was no association with interference in daily life after 6 weeks postpartum. Variation was observed in UI changes within the first year in the vaginal delivery and cesarean delivery groups.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cesarean Section*
  • Female
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Parturition*
  • Postoperative Complications* / epidemiology
  • Pregnancy
  • Prevalence
  • Prospective Studies
  • Puerperal Disorders / epidemiology
  • Puerperal Disorders / etiology*
  • Quality of Life
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Time Factors
  • Urinary Incontinence / epidemiology
  • Urinary Incontinence / etiology*
  • Young Adult