title: Multiple vaginal deliveries increase the risk of permanent incontinence of flatus urine in normal premenopausal women.
abstract: OBJECTIVE
  This study was undertaken to evaluate the risk of permanent flatus or urinary incontinence after repeated vaginal deliveries.
  
  
  METHODS
  In 1989 a questionnaire on obstetric history and urinary and fecal incontinence was sent to a sample of 304 women selected from the birth records from 1976 to 1988; 242 responded (80 percent).
  
  
  RESULTS
  Participants had one, two, or three vaginal deliveries, all without an obstetric tear of the anal sphincter. After the first, second, and third deliveries, 1.2, 1.5, and 8.3 percent developed permanent flatus incontinence. The risk was significantly increased after the third delivery compared with the first and second deliveries (odds ratio, 6.6; confidence interval, 2.4-18.3). Permanent urinary incontinence after the first, second, and third delivery developed in 3.3, 1.0, and 6.8 percent. The risk was significantly increased after the third delivery compared with the first and second (odds ratio, 3.2; confidence interval, 1.1-9.1).
  
  
  CONCLUSIONS
  These results indicate that repeated vaginal deliveries increase the risk of minor anal and urinary incontinence, which were found to be a common problem in premenopausal women.
authors.affiliation: Department of Gynaecology and Obstetrics, University Hospital of Aarbus, Denmark,
authors.forename: A M
authors.initials: AM
authors.lastname: Ryhammer
authors.forename: K M
authors.initials: KM
authors.lastname: Bek
authors.forename: S
authors.initials: S
authors.lastname: Laurberg
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D005414:Flatulence; D006801:Humans; D010298:Parity; D011247:Pregnancy; D017697:Premenopause; D012307:Risk Factors; D013223:Statistics as Topic; D014549:Urinary Incontinence / Q000209:etiology*