Incontinence more likely to occur after vaginal delivery

Women who give birth vaginally are at increased risk of long-term urinary incontinence (UI), but a new study suggests that this risk may be mitigated by shortening the duration of the second stage of labour.

Researchers used data from a large population of mothers who participated in the Maternal Follow up in the Danish National Birth Cohort. Logistic regression was used to examine parity, mode of birth, and obstetric tears in relation with urinary incontinence.

A total of 39,977 mothers (mean age 43.9 years) were included in the analysis. The prevalence rate of any urinary incontinence was 32 percent, with most women having stress urinary incontinence (21 percent).

In terms of parity, urinary incontinence was more common among women with two births than among those with one birth (odds ratio [OR], 1.20, 95 percent confidence interval [CI], 1.10–1.31). In terms of mode of birth, a history of only caesarean sections was associated with a lower likelihood of urinary incontinence (OR, 0.39, 95 percent CI, 0.35–0.42), while a history of instrumental births with slightly lower likelihood (OR, 0.92, 95 percent CI, 0.86–0.98) as compared with only spontaneous births.

As for obstetric tears, the odds of urinary incontinence were lower among women with episiotomy (OR, 0.91, 95 percent CI, 0.86–0.97) and higher among those with third/fourth-degree tears (OR, 1.14, 95 percent CI, 1.04–1.25) relative to women with no tear or a first-degree tear as the largest tear.

The findings, according to researchers were mainly explained by similar associations with stress and mixed urinary incontinence.