Vaginal Delivery Triples Risk Of Incontinence 20 Years After Child Birth

Women are nearly three times more likely to experience urinary incontinence for more than 10 years following a vaginal delivery rather than a caesarean section, finds new research at the Sahlgrenska Academy at the University of Gothenburg, Sweden.

Urinary incontinence (UI) is a common condition affecting adult women of all ages and can have a negative influence on quality of life. This new study from the University of Gothenburg in Sweden looked at the prevalence and risk factors for UI 20 years after vaginal delivery (VD) or caesarean section (CS). The study included women who had only one child and assessed their prevalence of UI for less than five years, between 5-10 years and for more than 10 years.

Over six thousand women involved

The SWEPOP (Swedish pregnancy, obesity and pelvic floor) study was conducted in 2008 and data were obtained from the Medical Birth Register (MBR) for deliveries between 1985 and 1988. A questionnaire was sent to women and 6, 148 completed it answering questions on height, weight, urinary or anal incontinence, genital prolapse, menstrual status, hysterectomy, the menopause and hormone treatment.

Prevalence of incontinence tripled

Overall, the prevalence of UI was considerably higher after a vaginal delivery (40.3%) compared to women who delivered by caesarean section (28.8%). The study also found that the prevalence of UI for more than 10 years almost tripled after VD (10.1%) compared to women who had a CS (3.9%).

Overweight also a risk factor

In addition, the paper looks at the impact of BMI on UI. The risk increase of UI in obese women more than doubled in comparison to women with a normal BMI after VD and more than tripled after CS.

Many risk factors

Maria Gyhagen, Department of Obstetrics and Gynaecology, Sahlgrenska Academy, University of Gothenburg, Sweden and co-author of the paper said: "In conclusion, the risk of developing urinary incontinence was higher 20 years after a vaginal delivery compared to a caesarean section.

"There are many factors affecting urinary incontinence but obesity and ageing as well as obstetric trauma during childbirth are known to be three of the most important risk factors."

Affects daily life

BJOG Deputy Editor-in-Chief, Pierre Martin-Hirsch, added: "Urinary incontinence affects many women and can have a big impact on day to day life.

"However, women need to look at all the information when deciding on mode of delivery as despite vaginal delivery and BMI being linked to urinary incontinence, caesarean section involves its own risks."