The second stage of labor and stress urinary incontinence

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1067/mob.2001.114856 Byline: Katherine Van Kessel (a), Susan Reed (a), Katherine Newton (b), Amalia Meier (c), Gretchen Lentz (a) Keywords: Stress incontinence; labor; forceps Abstract: Objective: This study was undertaken to investigate the potential association between prolonged second stage of labor and stress urinary incontinence. Study Design: A retrospective, population-based study was performed. A random, case-controlled sample of 85 cases and 88 controls was identified by means of a standard computerized patient database. Subjects were identified by International Classification of Diseases, Ninth Revision codes, and medical records were reviewed. The median follow-up time from delivery was 7.8 years for cases and 7.2 years for controls. Multiple logistic regression was performed to test for an association between stress urinary incontinence and variables of interest. Results: The data suggest that for all women who labored the length of the second stage of labor for the first delivery was not associated with stress urinary incontinence (odds ratio, 1.07; P = .42; 95% confidence interval, 0.9-1.3). However, forceps delivery was associated with a significant increase in stress urinary incontinence risk (odds ratio, 10.4; P = .04; 95% confidence interval, 1.2-93.4). Conclusion: Length of second stage of labor was not associated with stress urinary incontinence. However, the odds of having a later diagnosis of stress urinary incontinence was 10 times higher for women who underwent forceps delivery. (Am J Obstet Gynecol 2001;184:1571-5.) Author Affiliation: (a) Department of Obstetrics and Gynecology, University of Washington Medical Center, Harborview Medical Center Seattle, Washington (b) Center for Health Studies, Group Health Cooperative of Puget Sound Seattle, Washington (c) Department of Biostatistics, University of Washington School of Public Health and Community Medicine. Seattle, Washington Article Note: (footnote) [star] Reprints not available from the authors.