Vaginal birth not associated with incontinence later in life
ACOG NEWS RELEASE
For Release: November 30, 2005
Contact: ACOG Office of Communications
(202) 484-3321
communications@acog.org
Vaginal Birth Not Associated With Incontinence Later in Life
Washington, DC — Contrary to the belief held by some, vaginal birth does not
appear to be associated with incontinence later in life, a new study has found.
The study, published in the December issue of Obstetrics & Gynecology,
found that incontinence was more strongly related with family history.
An estimated 30-50% of adult women suffer from urinary incontinence, and
vaginal delivery is often considered to be the major risk factor for stress
urinary incontinence. While 62% of urogynecologists previously surveyed
would support performing elective cesarean deliveries to prevent
incontinence in the long term, the benefit of this practice has not been proven.
Risk factors for incontinence include body mass index, hypertension, and
integrity of the pelvic floor, all of which tend to run in families.
Researchers from the University of Rochester Medical Center in New York
studied 143 pairs of biological sisters. All of the women were at least 45 years
old and postmenopausal. All but two pairs of sisters were Caucasian.
However, one sister of each pair was nulliparous (no deliveries) and one was
parous (at least one vaginal delivery). The women answered questionnaires
and underwent clinical testing to measure incontinence.
The researchers found that the rate of incontinence was 47.6% for nulliparous
women and 49.7% for parous women, a statistically insignificant difference.
They did discover, however, that 63% of the pairs shared continence status
(i.e. either both were continent or both were incontinent). The researchers say
that their findings run contrary to the conventional wisdom that nulliparity
protects against incontinence and are similar to findings from their earlier
study of nuns who had never given birth and yet still had high rates of
postmenopausal incontinence.
While further research is needed to determine if there is a genetic component
to incontinence, the researchers say that this study indicates that family
history is more strongly associated with incontinence than a history of vaginal
delivery.
Contact: Gunhilde M. Buchsbaum, MD, University of Rochester Medical
Center, Rochester, NY, at gunhilde_buchsbaum@urmc.rochester.edu.
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