Childbirth not linked to urinary incontinence

Postmenopausal women who have given birth vaginally do not appear to suffer from urinary incontinence at higher rates than their sisters who have never given birth, according to a University of Rochester Medical Center study published in the December Obstetrics and Gynecology journal.

The study results are contrary to conventional thinking that vaginal delivery will result in urinary incontinence later in life. In fact, elective caesarean sections are now being performed for the sole purpose of preventing future incontinence, the authors report, even though the scientific literature is inconsistent on this link.

In the current study, lead author Gunhilde Buchsbaum, M.D., compared 143 pairs of biological, postmenopausal sisters from western New York and northern Vermont. The sisters completed a comprehensive questionnaire about their symptoms of pelvic floor disorders, and 101 pairs underwent a clinical evaluation.

The results: 49.7 percent of the women who had given birth reported some degree of urinary incontinence compared to 47.6 percent of the women who had never given birth. The difference is not statistically significant. Instead, an underlying genetic predisposition seemed to play the largest role in determining risk. The results showed that in 63 percent of the sisters, if one experienced urinary incontinence the other sister also did.

"The family history and genetic predisposition is something that definitely needs to be explored further," said Buchsbaum, an associate professor of obstetrics and gynecology at the University of Rochester. "If we can find a clear genetic link, it would have great implications for the direction of basic research, treatment approaches, risk management and potential prophylactic interventions."