Login to Access Video or Poster Abstract: MP63-01
Sources of Funding: none

Introduction

Urinary incontinence (UI) is a prevalent condition that affects women’s quality of life. The female pelvic floor experiences trauma and strain during pregnancy and childbirth that can predispose women to UI. As the average age of pregnancies increases, more women are giving birth at an advanced maternal age (AMA). However, it is unclear what affect childbirth and pregnancy might have on the pelvic floor and UI in women of AMA. We aim to evaluate patient-reported UI outcomes in US women that have undergone a single childbirth at younger ages and those of AMA.

Methods

The NHANES database was queried for all primiparous women during the years 2005-2012. Women were excluded that had multiple deliveries, prior hysterectomy, pelvic organ prolapse, had given birth greater than 20 years from the time of survey and had given birth less than 2 years from time of survey. Nulliparous women (NP) aged 20-65 years were used for baseline incontinence rates. Women that had undergone childbirth were stratified by type of delivery and age at time of delivery with women 35 years or older classified as AMA. Cohorts were created composed of NP, young cesarean (YC), young vaginal (YV), AMA cesarean (AMAC), and AMA vaginal (AMAV). Multivariable logistic regression was performed to assess the effect of delivery type and AMA on urinary outcomes when adjusting for age and BMI.

Results

A total of 4,270 women met our inclusion criteria. AMAV had the highest rate of any UI (62.7%) and stress UI (50.6%), compared to all other groups. When adjusting for age and BMI; women undergoing vaginal deliveries (YV and AMAV) had increased UI and SUI. There were no differences seen in urge UI between all groups. YV and AMAV also had increased bother with UI and an increased severity of incontinence. When looking between groups, there were no differences in UI between YC and AMAC (OR 1.1). In addition, there was no difference in UI between YV and AMAV (OR 1.2).

Conclusions

It appears that AMA does not have an effect on UI when stratified by delivery type. Any differences seen in patient-reported UI are driven by a vaginal delivery, regardless of age at time of childbirth. Primiparous women undergoing a cesarean delivery have similar UI outcomes to nulliparous women.

Funding

none