Original Clinical Article
Article first published online: 20 JUL 2011
Copyright © 2011 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 30, Issue 8, pages 1456–1461, November 2011
How to Cite
Thom, D. H., Brown, J. S., Schembri, M., Ragins, A. I., Creasman, J. M. and Van Den Eeden, S. K. (2011), Parturition events and risk of urinary incontinence in later life. Neurourol. Urodyn., 30: 1456–1461. doi: 10.1002/nau.21166
Linda Brubaker led the review process.
Conflict of interest: none.
- Issue published online: 19 OCT 2011
- Article first published online: 20 JUL 2011
- Manuscript Accepted: 9 MAY 2011
- Manuscript Received: 25 FEB 2011
- National Institutes Diabetes, Digestive and Kidney Diseases. Grant Number: DK53335
- National Institutes Diabetes, Digestive and Kidney Diseases
- Office of Research on Women's Health Specialized Center of Research. Grant Number: P50 DK064538
- cohort study;
- induction of labor;
- risk factors;
- urinary incontinence;
- vaginal delivery
To examine the association between specific events during vaginal deliveries and urinary incontinence later in life.
A retrospective cohort study of 1,521 middle-aged and older women with at least one vaginal delivery who were long-term members of an integrated health delivery system. Age, race/ethnicity, current incontinence status, medical, surgical history, pregnancy and parturition history, menopausal status, hormone replacement, health habits, and general health were obtained by questionnaire. Labor and delivery records, archived since 1948, were abstracted by professional medical record abstractors to obtain parturition events including induction, length of labor stages, type of anesthesia, episiotomy, instrumental delivery, and birth weight. The primary dependent variable was current weekly urinary incontinence (once per week or more often) versus urinary incontinence less than monthly (including no incontinence) in past 12 months. Associations of parturition events and later incontinence were assessed in multivariate analysis with logistic regression.
The mean age of participants was 56 years. After adjustment for multiple risk factors, weekly urinary incontinence significantly associated with age at first birth (P = 0.036), greatest birth weight (P = 0.005), and ever having been induced for labor (OR = 1.51; 95%CI = 1.06–2.16, P = 0.02). Risk of incontinence increased from OR = 1.35 (95%CI = 0.92–1.97, P = 0.12) for women with one induction to OR = 2.67 (95%CI = 1.25–5.71, P = 0.01) for women with two or more inductions (P = 0.01 for trend). No other parturition factors were associated with incontinence.
Younger age at first birth, greatest birth weight, and induction of labor were associated with an increased risk of incontinence in later life. Neurourol. Urodynam. Neurourol. Urodynam. 30: 1456–1461, 2011. © 2011 Wiley Periodicals, Inc.