{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T07:42:00Z","timestamp":1782891720175,"version":"3.54.5"},"reference-count":13,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2018,8,27]],"date-time":"2018-08-27T00:00:00Z","timestamp":1535328000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MCT\u201063164"],"award-info":[{"award-number":["MCT\u201063164"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Does planned caesarean compared with planned vaginal birth lower the risk of problematic urinary stress, faecal, or flatal incontinence?<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Women between 32<jats:sup>0\/7<\/jats:sup> and 38<jats:sup>6\/7<\/jats:sup> weeks of gestation with a twin pregnancy were randomised to planned caesarean or planned vaginal birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The trial took place at 106 centres in 25 countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>A total of 2305 of the 2804 women enrolled in the study completed questionnaires at 2 years (82.2% follow\u2010up): 1155 in the planned caesarean group and 1150 in the planned vaginal birth group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A structured self\u2010administered questionnaire completed at 2 years postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The primary maternal outcome of the Twin Birth Study was problematic urinary stress, or fecal, or flatal incontinence at 2 years<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u20130.83; <jats:italic>P<\/jats:italic> = 0.001]. Among those with problematic urinary stress incontinence, quality of life (measured using the Incontinence Impact Questionnaire, <jats:styled-content style=\"fixed-case\">IIQ<\/jats:styled-content>\u20107) was not different for planned caesarean versus planned vaginal birth groups [mean (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>): 18.4 (21.0) versus 19.1 (21.5); <jats:italic>P<\/jats:italic> = 0.82]. There were no differences in problematic faecal or flatal incontinence, or in other maternal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Funding<\/jats:title><jats:p>Canadian Institutes of Health Research (<jats:styled-content style=\"fixed-case\">CIHR<\/jats:styled-content>) (grant no. MCT\u201063164).<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15407","type":"journal-article","created":{"date-parts":[[2018,7,14]],"date-time":"2018-07-14T17:24:44Z","timestamp":1531589084000},"page":"1682-1690","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Urinary stress incontinence and other maternal outcomes 2 years after caesarean or vaginal birth for twin pregnancy: a multicentre randomised trial"],"prefix":"10.1111","volume":"125","author":[{"given":"EK","family":"Hutton","sequence":"first","affiliation":[{"name":"Division of Midwifery Department of Obstetrics and Gynecology McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ME","family":"Hannah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AR","family":"Willan","sequence":"additional","affiliation":[{"name":"Program in Child Health Evaluative Sciences Sick Kids Research Institute Dalla Lana School of Public Health University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Alberta Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AC","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics IWK Health Centre Dalhousie University Halifax NS Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"BA","family":"Armson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology IWK Health Centre Dalhousie University Halifax NS Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Gafni","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KS","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology School of Population and Public Health University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Mangoff","sequence":"additional","affiliation":[{"name":"The Centre for Mother, Infant, and Child Research Sunnybrook Research Institute Sunnybrook Health Sciences Centre University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Ohlsson","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Mount Sinai Hospital University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JJ","family":"Sanchez","sequence":"additional","affiliation":[{"name":"The Centre for Mother, Infant, and Child Research Sunnybrook Research Institute Sunnybrook Health Sciences Centre University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EV","family":"Asztalos","sequence":"additional","affiliation":[{"name":"Department of Newborn &amp; 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