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Association of Mode of Delivery With Urinary Incontinence and Changes in Urinary Incontinence Over the First Year Postpartum

Chang, Shiow-Ru RN, PhD; Chen, Kuang-Ho PhD; Lin, Ho-Hsiung MD, PhD; Lin, Ming-I MD; Chang, Ting-Chen MD; Lin, Wei-An MD

doi: 10.1097/AOG.0000000000000141
Contents: Original Research

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.

LEVEL OF EVIDENCE: II

Vaginal delivery is associated with higher urinary incontinence prevalence that persists for 1 year postpartum, but there is no association with interference in daily life after 6 weeks postpartum.

School of Nursing and the Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, and Shin Kong Wu Ho-Su Memorial Hospital, Taipei, and Central Taiwan University of Science and Technology, Taichung, Taiwan.

Corresponding author: Shiow-Ru Chang, RN, PhD, School of Nursing, College of Medicine and Hospital, National Taiwan University, No. 1, Section 1, Jen-Ai Road, 100 Taipei, Taiwan; e-mail: srchang@ntu.edu.tw.

Supported by the National Science Council in Taiwan.

The authors thank Ms Chiou-Ru Lin for data collection.

Financial Disclosure The authors did not disclose any conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.