Vaginal delivery increases incontinence risk up to 20 years later

Compared with women who deliver via cesarean, women who deliver vaginally are 67% more likely to experience urinary incontinence up to 20 years after the birth and are almost three times as likely to be incontinent for more than 10 years, Swedish researchers report.

Vaginal delivery increases both the likelihood of incontinence and the probability that the condition will be of long duration, say the authors, who reported their findings online in BJOG (March 14, 2012).

Obstetrician-gynecologists from Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden and Södra Älvsborgs Hospital, Borås, Sweden conducted a registry-based national cohort study involving more than 5,000 primigravidas who delivered a single infant between 1985 and 1988 and had no subsequent births. The results revealed that 40.3% of the women who delivered vaginally experienced urinary incontinence versus 28.8% of those who delivered surgically (odds ratio [OR], 1.67; 95% CI, 1.45-1.92). In addition, 10.1% of those who delivered vaginally were incontinent for more than 10 years versus 3.9% of women who delivered surgically (OR, 2.75; 95% CI, 2.02-3.75).

No differences existed with regard to urinary incontinence between women who had an acute cesarean delivery and those who had the procedure electively, indicating that the fetus passing through the pelvic floor in the late stage of delivery increases the risk of urinary incontinence later, the authors wrote.

Also, the risk of urinary incontinence in obese women was more than twice that of normal-weight women after vaginal delivery and more than triple that of normal-weight counterparts after cesarean delivery. In addition, the prevalence of urinary incontinence was 10% higher in women aged ≥35 years at delivery compared with women aged

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