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Risk of new-onset urinary incontinence 3 and 12 months after vaginal or cesarean delivery of twins: Part I

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Abstract

Introduction and hypothesis

Our purpose was to compare the prevalence of urinary incontinence (UI) 3 and 12 months after vaginal vs cesarean delivery of twins after 34 weeks of gestation.

Methods

This was a multicenter prospective cohort study conducted at 172 French maternity units and included 2812 primiparous women with twins with no prior history of UI. Participants were enrolled at the time of delivery and followed up to 12 months postpartum. The primary outcome was the prevalence of UI, both stress and urge, 3 months postpartum, based on the patient reporting any frequency of urine leakage to the first question of the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). The Pelvic Floor Distress Inventory - Short Form 20 (PFDI-20), Pelvic Floor Impact Questionnaire - Short Form 7 (PFIQ-7), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and Medical Outcome Study Short Form-12 (SF-12) were also used.

Results

The ICIQ-SF was completed by 1155 (39.8%) and 800 (27.5%) women, respectively, at 3 and 12 months postpartum; 556 (48%) had delivered vaginally and 599 (52%) by cesarean section. The prevalence of UI at 3 months was 26% overall and was significantly higher in the vaginal delivery group at both 3 months (35% vs 17% in the cesarean group, p < 0.0001) and 12 months postpartum (38% vs 24%, p < 0.0001). UI was predominantly stress or mixed. The risk factors for UI at 3 months, determined by multivariate modeling, were vaginal delivery [odds ratio (OR) 3.073, 95% confidence interval (CI) 2.3–4.105, p < 0.0001) and body mass index >25 in early pregnancy (OR 1.620, 95% CI 1.188–2.209, p = 0.0023).

Conclusions

Vaginal delivery is a risk factor for UI at 3 months after twin birth.

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Funding

This study was funded by the Nimes University Hospital (AOI GCS Merri Nîmes-Montpellier).

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Carémeau University Hospital, Nîmes, France

    Renaud de Tayrac, Fanny Béchard & Vincent Letouzey

  2. Obs/Gyne Dept, Nimes University Horpital, Place du Prof Debre, 30900, Nîmes, France

    Renaud de Tayrac

  3. Department of Biostatistics, Epidemiology, Public Health and Medical Information (BESPIM), Nîmes University Hospital, Nîmes, France

    Christel Castelli & Sandrine Alonso

  4. Department of Obstetrics and Gynecology, Arnaud de Villeneuve University Hospital, Montpellier, France

    Emmanuelle Vintejoux

  5. INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France

    François Goffinet

  6. Department of Obstetrics and Gynecology, Robert Debré University Hospital, Paris, France

    Thomas Schmitz

Authors
  1. Renaud de Tayrac
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  2. Fanny Béchard
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  3. Christel Castelli
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  4. Sandrine Alonso
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  5. Emmanuelle Vintejoux
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  6. François Goffinet
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  7. Vincent Letouzey
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  8. Thomas Schmitz
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Corresponding author

Correspondence to Renaud de Tayrac.

Ethics declarations

Conflicts of interest

None.

Details of ethics approval

The study was approved by the Comité consultatif sur le traitement de l’information en matière de recherche dans le domaine de la santé and by the Commission Nationale de l’Informatique et des Libertés (autorization no. 913,448).

The study was recorded on Clinicaltrials.gov no. NCT02059746.

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de Tayrac, R., Béchard, F., Castelli, C. et al. Risk of new-onset urinary incontinence 3 and 12 months after vaginal or cesarean delivery of twins: Part I. Int Urogynecol J 30, 881–891 (2019). https://doi.org/10.1007/s00192-018-3774-4

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  • DOI: https://doi.org/10.1007/s00192-018-3774-4

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