title: The second stage of labor and stress urinary incontinence.
abstract: OBJECTIVE
  This study was undertaken to investigate the potential association between prolonged second stage of labor and stress urinary incontinence.
  
  
  METHODS
  A retrospective, population-based study was performed. A random, case-controlled sample of 85 cases and 88 controls was identified by means of a standard computerized patient database. Subjects were identified by International Classification of Diseases, Ninth Revision codes, and medical records were reviewed. The median follow-up time from delivery was 7.8 years for cases and 7.2 years for controls. Multiple logistic regression was performed to test for an association between stress urinary incontinence and variables of interest.
  
  
  RESULTS
  The data suggest that for all women who labored the length of the second stage of labor for the first delivery was not associated with stress urinary incontinence (odds ratio, 1.07; P =.42; 95% confidence interval, 0.9-1.3). However, forceps delivery was associated with a significant increase in stress urinary incontinence risk (odds ratio, 10.4; P =.04; 95% confidence interval, 1.2-93.4).
  
  
  CONCLUSIONS
  Length of second stage of labor was not associated with stress urinary incontinence. However, the odds of having a later diagnosis of stress urinary incontinence was 10 times higher for women who underwent forceps delivery.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington Medical Center, Seattle, USA.
authors.forename: K
authors.initials: K
authors.lastname: Van Kessel
authors.forename: S
authors.initials: S
authors.lastname: Reed
authors.forename: K
authors.initials: K
authors.lastname: Newton
authors.forename: A
authors.initials: A
authors.lastname: Meier
authors.forename: G
authors.initials: G
authors.lastname: Lentz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007748:Labor Stage, Second / Q000502:physiology*; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000209:etiology*; D016017:Odds Ratio; D011247:Pregnancy; D012189:Retrospective Studies; D013525:Surgical Instruments / Q000009:adverse effects; D013997:Time Factors; D014550:Urinary Incontinence, Stress / Q000209:etiology*