TY - JOUR
T1 - Delivery mode is a major environmental determinant of stress urinary incontinence
T2 - Results of the Evanston-Northwestern Twin Sisters Study
AU - Goldberg, Roger P.
AU - Abramov, Yoram
AU - Botros, Sylvia
AU - Miller, Jay James
AU - Gandhi, Sanjay
AU - Nickolov, Angel
AU - Sherman, Wendy
AU - Sand, Peter K.
PY - 2005/12
Y1 - 2005/12
N2 - Objective: We studied a large cohort of identical twin sisters, utilizing the unique properties of a twin research design to explore the relationship between obstetrical delivery mode and stress urinary incontinence. Study design: An anonymous 67-item survey was completed by 271 identical twin pairs (n = 542) at the world's largest annual gathering of twins. Logistic regression for repeated binary measures was used to evaluate risk factors and accounting for shared genetics within pairs. Results: The twins had a mean age of 47.1 years (range 15 to 85 years), and stress urinary incontinence was reported by 51.8%. Stress urinary incontinence was associated with age (P = .001), parity (P = .001), obesity (P = .002), and birth mode, with vaginal delivery conferring a considerable increase in stress urinary incontinence risk relative to cesarean section (odds ratio 2.28, 95% confidence interval 1.14 to 4.55, P = .019). Conclusion: Vaginal delivery mode represents a potent determinant of stress urinary incontinence, carrying more than twice the risk of cesarean section. This study of identical twins provides new insight into the epidemiology of female incontinence.
AB - Objective: We studied a large cohort of identical twin sisters, utilizing the unique properties of a twin research design to explore the relationship between obstetrical delivery mode and stress urinary incontinence. Study design: An anonymous 67-item survey was completed by 271 identical twin pairs (n = 542) at the world's largest annual gathering of twins. Logistic regression for repeated binary measures was used to evaluate risk factors and accounting for shared genetics within pairs. Results: The twins had a mean age of 47.1 years (range 15 to 85 years), and stress urinary incontinence was reported by 51.8%. Stress urinary incontinence was associated with age (P = .001), parity (P = .001), obesity (P = .002), and birth mode, with vaginal delivery conferring a considerable increase in stress urinary incontinence risk relative to cesarean section (odds ratio 2.28, 95% confidence interval 1.14 to 4.55, P = .019). Conclusion: Vaginal delivery mode represents a potent determinant of stress urinary incontinence, carrying more than twice the risk of cesarean section. This study of identical twins provides new insight into the epidemiology of female incontinence.
KW - Childbirth
KW - Epidemiology
KW - Identical twins
KW - Stress urinary incontinence
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U2 - 10.1016/j.ajog.2005.08.055
DO - 10.1016/j.ajog.2005.08.055
M3 - Article
C2 - 16325632
AN - SCOPUS:28444454969
SN - 0002-9378
VL - 193
SP - 2149
EP - 2153
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 6
ER -