Delayed childbearing: Effect of age on pregnancy outcomes and postpartum incontinence

Study Objective: To examine the impact of maternal age on pregnancy outcomes and postpartum incontinence among primiparous women.

Methods: Primiparous women were identified from a population-based survey conducted in the state of Oregon between 2002 and 2003. Differences were compared between women 30 years and older to women under age 30 using t-test and Chi square. Pregnancy outcomes and postpartum incontinence were examined by logistic regression and generalized additive model.

Results: 6140 primiparous women were identified, 2165 (35%) of whom were aged 30 or older. Older primiparas were significantly more likely to deliver by cesarean (36% vs. 24%), including elective cesarean (10.5% vs. 6.2%), and more likely to push over 2 hours (36% vs. 26%). Older primiparas were 38% more likely have device assisted deliveries (vacuum or forceps) and 60% more likely to have a laceration. Among women who delivered vaginally, the risk of urinary incontinence increased significantly after age 30 and fecal incontinence after age 33.

Conclusions: Women 30 years and older are at increased risk for labor abnormalities and postpartum fecal and urinary incontinence. Given the aging population and tendency to delay childbirth, these findings have huge public policy implications economically and regarding the health and quality of life of women. Understanding the causes and potential preventive strategies for these risks, should be a high priority for public health researchers.