Association of mode of delivery with urinary incontinence and changes in urinary incontinence over the first year postpartum.
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.


CONCLUSIONS
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.
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.
Shiow-Ru
SR
Chang
Kuang-Ho
KH
Chen
Ho-Hsiung
HH
Lin
Ming-I
MI
Lin
Ting-Chen
TC
Chang
Wei-An
WA
Lin
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D036801:Parturition; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000453:epidemiology / Q000209:etiology*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult