OBJECTIVE

To evaluate the association of route of delivery in primiparae with prevalence of urinary incontinence.

METHODS

One thousand primiparae who had birth deliveries from March 2001 to March 2002 in our hospital were telephone interviewed through a questionnaire about symptoms of urinary incontinence before and during pregnancy, and after delivery. Totally 548 women answered the questionnaire based on International Consultant on Incontinence completely. The incidence and degrees of different kinds of urinary incontinence in connection with different ways of delivery and the associated factors were evaluated using SPSS software.

RESULTS

(1) Among 548 cases, urinary incontinence was diagnosed in 167 (30.5%). (2) According to logistic regression, cesarean section and neonatal weight were associated factors with incontinence. If the odds ratio (OR) were taken as 1.0 for the incontinence women who had a normal vaginal delivery, then OR for cesarean section would be 0.326. OR for neonatal weight would be 1.633. Neonatal weight was the only high risk factor related with incontinence in women with vaginal delivery (P = 0.013, OR = 2.081). (3) The incidence of urinary incontinence in spontaneous vaginal delivery, forceps and cesarean section was 38.6% (105/272), 43.8% (21/48) and 18.0% (41/228) respectively. There was no difference in the incidence of urinary incontinence between spontaneous vaginal delivery and forceps (P > 0.05). A lower incidence of urinary incontinence was found in cesarean section than in other ways of delivery (P < 0.05). (4) The incidences of stress urinary incontinence, mixed incontinence and urgent incontinence were 33.8%, 4.4% and 0.4% respectively in spontaneous vaginal delivery; 35.4%, 8.3% and 0% in forceps delivery; and 14.5%, 3.1% and 0.4% in cesarean section. The incidence of stress urinary incontinence was higher in vaginal delivery women than in cesarean section women (P < 0.05). Severe cases of stress urinary incontinence were more in spontaneous vaginal delivery than in cesarean section (P < 0.05). (5) 1.2% (2/167) women reported urinary incontinence before pregnancy; 7.8% (13/167) during pregnancy; 44% (75/167) within one year after delivery; 40.7% (68/167) persisting for more than one year after delivery; and 2.4% (4/167) in recent time.

CONCLUSIONS

(1) Cesarean section may decrease the risk of urinary incontinence compared with vaginal delivery. (2) Most patients have the symptoms of incontinence within one year after delivery, with some lasting for more than one year. (3) Heavy fetal weight increases the risk of stress incontinence.