title: Pelvic organ prolapse and incontinence 15-23 years after first delivery: a cross-sectional study.
abstract: OBJECTIVE
  To study the association between pelvic floor dysfunction (PFD) and mode of delivery and to calculate the risks of PFD comparing caesarean delivery and operative vaginal delivery to normal vaginal delivery 15-23 years after childbirth. A subgroup analysis comparing forceps and vacuum delivery was planned.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Postal questionnaire.
  
  
  METHODS
  1641 (53%) of 3115 women who delivered their first child in Trondheim, Norway, between January 1990 and December 1997.
  
  
  METHODS
  A questionnaire including questions on symptomatic pelvic organ prolapse, urinary and fecal incontinence and surgery for these conditions.
  
  
  METHODS
  Prevalence of PFD measured by symptomatic pelvic organ prolapse or surgery (sPOP), urinary incontinence or surgery (UI) and fecal incontinence or surgery (FI).
  
  
  RESULTS
  When caesarean delivery was compared to normal vaginal delivery the adjusted odds ratio (aOR) for sPOP was 0.42 (95% confidence interval, CI, 0.21-0.86) and the aOR for UI was 0.65 (95% CI 0.46-0.92). Operative vaginal delivery was associated with increased risk of sPOP (aOR 1.73, 95% CI 1.21-2.48) and FI (aOR 1.96, 95% CI 1.26-3.06) when compared with normal vaginal delivery. There were no differences in sPOP, UI or FI in a subgroup analysis comparing forceps and vacuum delivery.
  
  
  CONCLUSIONS
  Caesarean delivery was associated with decreased risk and operative vaginal delivery with increased risk of pelvic floor dysfunction 15-23 years after first delivery, but there were no differences between forceps and vacuum delivery.
authors: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.|Department of Obstetrics and Gynaecology, Trondheim University Hospital, Trondheim, Norway.
authors: I
authors: I
authors: Volløyhaug
authors: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
authors: S
authors: S
authors: Mørkved
authors: Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
authors: Ø
authors: Ø
authors: Salvesen
authors: Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.|National Center for Fetal Medicine, Trondheim University Hospital, Trondheim, Norway.
authors: Kå
authors: K
authors: Salvesen
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000009:adverse effects / Q000706:statistics & numerical data*; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
keywords: Fecal incontinence; forceps delivery; pelvic floor dysfunction; pelvic organ prolapse; urinary incontinence; vacuum delivery