Association between vaginal or cesarean delivery and later development of stress urinary incontinence or pelvic organ prolapse: A retrospective population-based cohort study

被引:10
作者
Tsui, Wing Lam [1 ]
Deng, Guang-Hong [2 ]
Hsieh, Tsung-Cheng [2 ,3 ]
Ding, Dah-Ching [1 ,3 ]
机构
[1] Tzu Chi Univ, Hualien Tzu Chi Hosp, Buddhist Tzu Chi Med Fdn, Dept Obstet & Gynecol, Hualien 970, Taiwan
[2] Tzu Chi Univ, Res Ctr Big Data Teaching Res & Stat Consultat, Hualien 970, Taiwan
[3] Tzu Chi Univ, Inst Med Sci, Hualien 970, Taiwan
关键词
Cesarean delivery; Vaginal delivery; Stress urinary incontinence; Pelvic organ prolapse; Prognosis; RISK-FACTORS; PREVALENCE; MODE; EPIDEMIOLOGY; PREGNANCY; IMPACT; WOMEN;
D O I
10.1007/s00192-023-05504-6
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Introduction and hypothesisChild delivery mode may be associated with pelvic floor disorders. We explored the association between different delivery modes and later development of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in Taiwanese women.MethodsThis was a retrospective population-based cohort study. Women who delivered babies between January 1, 2000, and December 31, 2018, were selected for this study. The study used Taiwan's National Health Insurance (NHI) Research Database. After propensity score matching, 51,587 women who underwent cesarean section (C/S) and 51,587 women who underwent vaginal delivery (VD) were recruited. Primary outcomes were the presence of SUI and POP after delivery.ResultsThe incidence of SUI (1.6/1000 person-years) and POP (1.5/1000 person-years) was higher in the VD group than in the C/S group (0.8 and 0.6 in 1000 person-years). VD was associated with an increased risk of SUI [hazard ratio (HR): 2.79, 95% confidence interval (CI): 2.45-3.17] and POP (HR: 1.96, 95% CI: 1.75-2.19) compared to C/S. We also found that age (HR: 1.06, 95% CI: 1.05-1.08 in SUI, HR: 1.08, 95% CI: 1.07-1.09 in POP) and Charlson Comorbidity Index (CCI) (HR: 1.28, 95% CI: 1.12-1.46 in SUI, HR: 1.27, 95% CI: 1.13-1.43 in POP) were associated with an increased risk of SUI and POP. The cumulative incidence of SUI and POP was higher in the VD group than in the C/S group (log-rank test, P < 0.05).ConclusionsThe current study was the largest retrospective cohort study regarding the influence of delivery mode on SUI and POP so far. VD was found to be associated with an increased risk of SUI and POP compared with C/S. Postpartum care for pelvic physical therapy should be provided particularly to women undergoing VD.
引用
收藏
页码:2041 / 2047
页数:7
相关论文
共 42 条
[1]  
Aoki Y, 2017, NAT REV DIS PRIMERS, V3, DOI [10.1038/nrdp.2017.42, 10.1038/nrdp.2017.97]
[2]   Prevalence of pelvic organ prolapse and related factors in a general female population [J].
Aytan, Hakan ;
Ertunc, Devrim ;
Tok, Ekrem C. ;
Yasa, Osman ;
Nazik, Hakan .
TURKISH JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2014, 11 (03) :176-180
[3]   Epidemiology and outcome assessment of pelvic organ prolapse [J].
Barber, Matthew D. ;
Maher, Christopher .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2013, 24 (11) :1783-1790
[4]   Pelvic Floor Morbidity Following Vaginal Delivery versus Cesarean Delivery: Systematic Review and Meta-Analysis [J].
Barca, Juan A. ;
Bravo, Coral ;
Pintado-Recarte, Maria P. ;
Asunsolo, Angel ;
Cueto-Hernandez, Ignacio ;
Ruiz-Labarta, Javier ;
Bujan, Julia ;
Ortega, Miguel A. ;
De Leon-Luis, Juan A. .
JOURNAL OF CLINICAL MEDICINE, 2021, 10 (08)
[5]   Prevalence of Female Urinary Incontinence in the General Population According to Different Definitions and Study Designs [J].
Bedretdinova, Dina ;
Fritel, Xavier ;
Panjo, Henri ;
Ringa, Virginie .
EUROPEAN UROLOGY, 2016, 69 (02) :256-264
[6]   Trends and projections of caesarean section rates: global and regional estimates [J].
Betran, Ana Pilar ;
Ye, Jiangfeng ;
Moller, Ann-Beth ;
Souza, Joao Paulo ;
Zhang, Jun .
BMJ GLOBAL HEALTH, 2021, 6 (06)
[7]   Association of Delivery Mode With Pelvic Floor Disorders After Childbirth [J].
Blomquist, Joan L. ;
Munoz, Alvaro ;
Carroll, Megan ;
Handa, Victoria L. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2018, 320 (23) :2438-2447
[8]   International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training [J].
Bo, Kari ;
Angles-Acedo, Sonia ;
Batra, Achla ;
Braekken, Ingeborg Hoff ;
Chan, Yi Ling ;
Jorge, Cristine Homsi ;
Kruger, Jennifer ;
Yadav, Manisha ;
Dumoulin, Chantale .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2022, 33 (10) :2633-2667
[9]   Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction [J].
Bo, Kari .
WORLD JOURNAL OF UROLOGY, 2012, 30 (04) :437-443
[10]   Urinary incontinence in nulliparous women and their parous sisters [J].
Buchsbaum, GM ;
Duecy, EE ;
Kerr, LA ;
Huang, LS ;
Guzick, DS .
OBSTETRICS AND GYNECOLOGY, 2005, 106 (06) :1253-1258