title: Risk of surgically managed pelvic floor dysfunction in relation to age at first delivery.
abstract: OBJECTIVE
  The purpose of this study was to compare the risk of surgically treated stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in relation to mode of delivery and age at first childbirth.
  
  
  METHODS
  This was a cohort study. Data from the Swedish Medical Birth Register on women with only cesarean delivery (n = 30,880 women) or only vaginal delivery (n = 59,585 women) were compared with the Swedish Patient Register to calculate incidence rates and hazard ratios (95% confidence interval [CI]) for SUI and POP surgery.
  
  
  RESULTS
  In analyses that were stratified by age, vaginal delivery consistently increased the risks of SUI and POP surgery. Among vaginally delivered women who were ≥ 30 years old, incidence rates of POP surgery were 13.8 (95% CI, 12.7-15.1), and for younger women were 6.4 (95% CI, 6.0-6.8) per 10,000 person-years. Exclusion of instrumental vaginal delivery did not alter the conclusions.
  
  
  CONCLUSIONS
  Increasing age at first delivery increased the risk of subsequent SUI and POP surgery after both vaginal and cesarean delivery.
authors.affiliation: Department of Clinical Sciences at Karolinska Institutet, Division of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden. asa.leijonhufvud@live.se
authors.forename: Åsa
authors.initials: Å
authors.lastname: Leijonhufvud
authors.forename: Cecilia
authors.initials: C
authors.lastname: Lundholm
authors.forename: Sven
authors.initials: S
authors.lastname: Cnattingius
authors.forename: Fredrik
authors.initials: F
authors.lastname: Granath
authors.forename: Ellika
authors.initials: E
authors.lastname: Andolf
authors.forename: Daniel
authors.initials: D
authors.lastname: Altman
mesh_terms: D000328:Adult; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000009:adverse effects; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008423:Maternal Age; D017773:Pelvic Floor / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D012042:Registries; D012306:Risk; D014550:Urinary Incontinence, Stress / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery