Parity, mode of delivery, and pelvic floor disorders.
OBJECTIVE
This study aimed to assess the associations between parity, mode of delivery, and pelvic floor disorders.


METHODS
The prevalence of pelvic organ prolapse, stress urinary incontinence, overactive bladder, and anal incontinence was assessed in a random sample of women aged 25-84 years by using the validated Epidemiology of Prolapse and Incontinence Questionnaire. Women were categorized as nulliparous, vaginally parous, or only delivered by cesarean. Adjusted odds ratios and 95% confidence intervals (CIs) for each disorder were calculated with logistic regression, controlling for age, body mass index, and parity.


RESULTS
In the 4,458 respondents the prevalence of each disorder was as follows: 7% prolapse, 15% stress urinary incontinence, 13% overactive bladder, 25% anal incontinence, and 37% for any one or more pelvic floor disorders. There were no significant differences in the prevalence of disorders between the cesarean delivery and nulliparous groups. The adjusted odds of each disorder increased with vaginal parity compared with cesarean delivery: prolapse = 1.82 (95% CI 1.04-3.19), stress urinary incontinence = 1.81 (95% CI 1.25-2.61), overactive bladder = 1.53 (95% CI 1.02-2.29), anal incontinence = 1.72 (95% CI 1.27-2.35), and any one or more pelvic floor disorders = 1.85 (95% CI 1.42-2.41). Number-needed-to-treat analysis revealed that 7 women would have to deliver only by cesarean delivery to prevent one woman from having a pelvic floor disorder.


CONCLUSIONS
The risk of pelvic floor disorders is independently associated with vaginal delivery but not with parity alone. Cesarean delivery has a protective effect, similar to nulliparity, on the development of pelvic floor disorders when compared with vaginal delivery.


METHODS
II-2.
Lukacz
Emily S
ES
Women's Pelvic Medicine Center, University of California, San Diego, La Jolla, California 92037, USA. elukacz@ucsd.edu
Lawrence
Jean M
JM
Contreras
Richard
R
Nager
Charles W
CW
Luber
Karl M
KM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010298:Parity; D017773:Pelvic Floor / Q000503:physiopathology*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D014596:Uterine Prolapse / Q000453:epidemiology*