Associations Between the Number of Vaginal Delivery and Urinary Incontinence in Women Before and After Natural Menopause: A Cross-Sectional Study.

IF 2.6 4区 医学 Q2 OBSTETRICS & GYNECOLOGY
International Journal of Women's Health Pub Date : 2025-09-26 eCollection Date: 2025-01-01 DOI:10.2147/IJWH.S537859
Xuejiao Bai, Guanghui Li, Dongxia Yang, Hongli Ma, Hongxia Zhao, Xinming Yang
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引用次数: 0

Abstract

Purpose: Urinary Incontinence (UI) associates with menopausal status and vaginal delivery (VD). Existing literature has not confirmed a cumulative effect of an increasing number of VDs on UI incidence, while hormonal changes following natural menopause modulate the risk of UI. This study investigate the association between the number of VDs and UI by stratifying women based on menopausal status.

Patients and methods: This study examined the relationship between the number of VDs and categories of UI, including Stress Urinary Incontinence (SUI), Urge Urinary Incontinence (UUI), and Mixed Urinary Incontinence (MUI) in pre- and postmenopausal women, utilizing publically accessible data from the National Health and Nutrition Examination Survey (NHANES, 2007-2018). Weighted multivariable logistic regression, restricted cubic splines (RCS), and subgroup analyses with interaction tests were used to examine their association.

Results: This study comprised 4,046 premenopausal and 2,698 postmenopausal women. Adjusted multivariable regression analysis (Model 2) revealed that compared to nulliparous women, the risk of SUI significantly increased with ≥1 VDs in premenopausal women (1 VD: OR=2.53; 2 VDs: OR=3.73; ≥3 VDs: OR=2.94; all P<0.001) and with ≥2 VDs in postmenopausal women (2 VDs: OR=1.52; ≥3 VDs: OR=1.62, all P<0.05). MUI risk was elevated at 2 VD in both premenopausal (OR=1.78, P=0.012) and postmenopausal women (OR=1.57, P=0.049). No significant association was detected between the number of VDs and UUI in either group. RCS modeling revealed inverse U-shaped relationships between the number of VDs and SUI risk and L-shaped relationships with MUI risk across both groups (nonlinear P < 0.001).

Conclusion: The number of VDs exhibits positive associations with incident SUI and MUI, while no significant association was detected with UUI. Notably, the additional risk for SUI and MUI associated with the number of VDs was attenuated in postmenopausal women compared to premenopausal women. Prospective studies are warranted to validate the robustness of these associations.

自然绝经前后妇女阴道分娩次数与尿失禁之间的关系:一项横断面研究。
目的:尿失禁(UI)与绝经状态和阴道分娩(VD)有关。现有文献尚未证实VDs数量增加对尿失禁发生率的累积效应,而自然绝经后的激素变化可调节尿失禁的风险。本研究通过对绝经期妇女进行分层,探讨室性室间隔和尿失禁之间的关系。患者和方法:本研究利用国家健康和营养检查调查(NHANES, 2007-2018)的公开数据,研究了绝经前和绝经后妇女中vd数量与尿失禁类别(包括压力性尿失禁(SUI)、急迫性尿失禁(UUI)和混合性尿失禁(MUI))之间的关系。采用加权多变量logistic回归、限制性三次样条(RCS)和亚组分析及交互检验来检验它们之间的相关性。结果:这项研究包括4046名绝经前妇女和2698名绝经后妇女。经校正的多变量回归分析(模型2)显示,与未产妇女相比,绝经前妇女VDs≥1时SUI的风险显著增加(1 VD: OR=2.53; 2 VD: OR=3.73;≥3 VD: OR=2.94;均为p)。结论:VDs数量与SUI和MUI的发生呈正相关,与UUI无显著相关性。值得注意的是,与绝经前妇女相比,绝经后妇女与室性心律紊乱数量相关的SUI和MUI的额外风险有所降低。有必要进行前瞻性研究来验证这些关联的稳健性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Women's Health
International Journal of Women's Health OBSTETRICS & GYNECOLOGY-
CiteScore
3.70
自引率
0.00%
发文量
194
审稿时长
16 weeks
期刊介绍: International Journal of Women''s Health is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of women''s healthcare including gynecology, obstetrics, and breast cancer. Subject areas include: Chronic conditions including cancers of various organs specific and not specific to women Migraine, headaches, arthritis, osteoporosis Endocrine and autoimmune syndromes - asthma, multiple sclerosis, lupus, diabetes Sexual and reproductive health including fertility patterns and emerging technologies to address infertility Infectious disease with chronic sequelae including HIV/AIDS, HPV, PID, and other STDs Psychological and psychosocial conditions - depression across the life span, substance abuse, domestic violence Health maintenance among aging females - factors affecting the quality of life including physical, social and mental issues Avenues for health promotion and disease prevention across the life span Male vs female incidence comparisons for conditions that affect both genders.
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