Longitudinal analysis of the association between parity, mode of delivery and urinary incontinence in midlife using the SWAN cohort data

Parity increases the risk of urinary incontinence, but this risk differs by mode of delivery. This study evaluated the association between mode of delivery and prevalence of urge, stress, and mixed urinary incontinence in middle age. The association between mode of delivery and urinary incontinence subtypes was examined using data from the SWAN cohort. Women who experienced vaginal, cesarean, or combination deliveries were compared against nulliparous women. Women who delivered vaginally had a significantly higher prevalence of all subtypes of incontinence compared to women who were nulliparous or delivered via other modes. No significant differences in urinary incontinence were observed when comparing women who birthed vaginally, via cesarean, or combination to nulliparous women. However, in comparison to those who delivered via cesarean, women who delivered vaginally have significantly increased odds of experiencing stress urinary incontinence, and those who delivered via combination have significantly increased odds of experiencing mixed urinary incontinence. Urge urinary incontinence appears to be driven by aging, not childbearing. Compared to cesarean, vaginal deliveries increase the odds of stress and mixed urinary incontinence during middle age. Delivering via a combination of vaginal and cesarean sections increases the odds of mixed urinary incontinence during middle age.