biostudies-literatureHutton EKCanadian Institutes of Health Research1682-1690https://www.ebi.ac.uk/biostudies/studies/S-EPMC6282843biostudies-literatureUnknown125(13)<h4>Objective</h4>Does planned caesarean compared with planned vaginal birth lower the risk of problematic urinary stress, faecal, or flatal incontinence?<h4>Design</h4>Women between 32^0/7 and 38^6/7 weeks of gestation with a twin pregnancy were randomised to planned caesarean or planned vaginal birth.<h4>Setting</h4>The trial took place at 106 centres in 25 countries.<h4>Population</h4>A total of 2305 of the 2804 women enrolled in the study completed questionnaires at 2 years (82.2% follow-up): 1155 in the planned caesarean group and 1150 in the planned vaginal birth group.<h4>Methods</h4>A structured self-administered questionnaire completed at 2 years postpartum.<h4>Main outcome measures</h4>The primary maternal outcome of the Twin Birth Study was problematic urinary stress, or fecal, or flatal incontinence at 2 years RESULTS: Women in the planned caesarean group had lower problematic urinary stress incontinence rates compared with women in the planned vaginal birth group [93/1147 (8.11%) versus 140/1143 (12.25%); odds ratio, 0.63; 95% confidence interval, 0.47-0.83; P = 0.001]. Among those with problematic urinary stress incontinence, quality of life (measured using the Incontinence Impact Questionnaire, IIQ-7) was not different for planned caesarean versus planned vaginal birth groups [mean (SD): 18.4 (21.0) versus 19.1 (21.5); P = 0.82]. There were no differences in problematic faecal or flatal incontinence, or in other maternal outcomes.<h4>Conclusions</h4>Among women with a twin pregnancy and no prior history of urinary stress incontinence, a management strategy of planned caesarean compared with planned vaginal birth reduces the risk of problematic urinary stress incontinence at 2 years postpartum. Our findings show that the prevalence but not the severity of urinary stress incontinence was associated with mode of birth.<h4>Funding</h4>Canadian Institutes of Health Research (CIHR) (grant no. MCT-63164).<h4>Tweetable abstract</h4>For women with twins, planned caesarean compared with planned vaginal birth is associated with decreased prevalence but not severity of urinary stress incontinence at 2 years.BJOG : an international journal of obstetrics and gynaecologyUrinary stress incontinence and other maternal outcomes 2 years after caesarean or vaginal birth for twin pregnancy: a multicentre randomised trial.PMC6282843MCT‐63164MCT-63164Willan ARTwin Birth Study Collaborative GroupSanchez JJHannah MEAllen ACHutton EKMangoff KOhlsson ARoss SArmson BAJoseph KSGafni AAsztalos EVBarrett JfalseUrinary stress incontinence and other maternal outcomes 2 years after caesarean or vaginal birth for twin pregnancy: a multicentre randomised trial.<h4>Objective</h4>Does planned caesarean compared with planned vaginal birth lower the risk of problematic urinary stress, faecal, or flatal incontinence?<h4>Design</h4>Women between 32^0/7 and 38^6/7 weeks of gestation with a twin pregnancy were randomised to planned caesarean or planned vaginal birth.<h4>Setting</h4>The trial took place at 106 centres in 25 countries.<h4>Population</h4>A total of 2305 of the 2804 women enrolled in the study completed questionnaires at 2 years (82.2% follow-up): 1155 in the planned caesarean group and 1150 in the planned vaginal birth group.<h4>Methods</h4>A structured self-administered questionnaire completed at 2 years postpartum.<h4>Main outcome measures</h4>The primary maternal outcome of the Twin Birth Study was problematic urinary stress, or fecal, or flatal incontinence at 2 years RESULTS: Women in the planned caesarean group had lower problematic urinary stress incontinence rates compared with women in the planned vaginal birth group [93/1147 (8.11%) versus 140/1143 (12.25%); odds ratio, 0.63; 95% confidence interval, 0.47-0.83; P = 0.001]. Among those with problematic urinary stress incontinence, quality of life (measured using the Incontinence Impact Questionnaire, IIQ-7) was not different for planned caesarean versus planned vaginal birth groups [mean (SD): 18.4 (21.0) versus 19.1 (21.5); P = 0.82]. There were no differences in problematic faecal or flatal incontinence, or in other maternal outcomes.<h4>Conclusions</h4>Among women with a twin pregnancy and no prior history of urinary stress incontinence, a management strategy of planned caesarean compared with planned vaginal birth reduces the risk of problematic urinary stress incontinence at 2 years postpartum. Our findings show that the prevalence but not the severity of urinary stress incontinence was associated with mode of birth.<h4>Funding</h4>Canadian Institutes of Health Research (CIHR) (grant no. MCT-63164).<h4>Tweetable abstract</h4>For women with twins, planned caesarean compared with planned vaginal birth is associated with decreased prevalence but not severity of urinary stress incontinence at 2 years.2018-01-01T00:00:00Z2018 Dec2026-07-09T11:26:49.062Z2019-03-27T00:11:17ZS-EPMC62828433000711310.1111/1471-0528.15407