- Cesarean delivery is associated with a lower risk than spontaneous vaginal delivery for stress urinary incontinence (SUI), overactive bladder (OAB), and pelvic organ prolapse (POP), whereas operative vaginal delivery is linked to a higher risk for anal incontinence (AI) and POP.
Why this matters
- Childbirth-associated pelvic floor disorders affect approximately 25% of women in the United States, but little is known about their course and progression over time.
- 15-year cumulative incidences of pelvic floor disorders after spontaneous vaginal delivery (95% CIs):
- SUI: 34.3% (29.9%-38.6%).
- OAB: 21.8% (17.8%-25.7%).
- AI: 30.6% (26.4%-34.9%).
- POP: 30.0% (25.1%-34.9%).
- Risk after cesarean delivery (adjusted HRs; 95% CIs):
- SUI: 0.46 (0.32-0.67).
- OAB: 0.51 (0.34-0.76).
- POP: 0.28 (0.19-0.42).
- Risk after operative vaginal delivery (adjusted HRs; 95% CIs):
- AI: 1.75 (1.14-2.68).
- POP: 1.88 (1.28-2.78).
- Researchers studied women 5-10 years after first delivery and followed-up annually for ≤9 years (N=1528: 778 cesarean, 565 spontaneous vaginal births, 185 operative vaginal births).
- Funding: NIH.
- The study was single center and had a small sample size.