Evidence map›Paper›PMID 30007113›Full record

Trial reportBJOG : an international journal of obstetrics and gynaecology2018

Urinary stress incontinence and other maternal outcomes 2 years after caesarean or vaginal birth for twin pregnancy: a multicentre randomised trial.

E K Hutton, M E Hannah, A R Willan, S Ross, A C Allen, B A Armson, A Gafni, K S Joseph, K Mangoff, A Ohlsson and 4 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BJOG : an international journal of obstetrics and gynaecology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Twin Deliveries - East Meets West.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2022
    Review
  6. Review
  7. Article
  8. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 8 institutions in 1 country.

E K HuttonDivision of Midwifery, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
M E HannahDepartment of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada.
A R WillanProgram in Child Health Evaluative Sciences, Sick Kids Research Institute, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
S RossDepartment of Obstetrics and Gynaecology, University of Alberta, Edmonton, AB, Canada.
A C AllenDepartment of Paediatrics, IWK Health Centre, Dalhousie University, Halifax, NS, Canada.
B A ArmsonDepartment of Obstetrics and Gynaecology, IWK Health Centre, Dalhousie University, Halifax, NS, Canada.
A GafniDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
K S JosephDepartment of Obstetrics and Gynaecology, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
K MangoffThe Centre for Mother, Infant, and Child Research, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
A OhlssonDepartment of Paediatrics, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
J J SanchezThe Centre for Mother, Infant, and Child Research, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
E V AsztalosDepartment of Newborn & Developmental Paediatrics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Jfr BarrettDepartment of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Twin Birth Study Collaborative Group
University of Toronto · CASunnybrook Health Science Centre · CADalhousie University · CAImpact · CAIzaak Walton Killam Health Centre · CAMcMaster University · CAUniversity of Alberta · CAUniversity of British Columbia · CA

Funding

Canadian Institutes of Health Research MCT-63164
6 · The paper itself

Abstract

objectiveDoes planned caesarean compared with planned vaginal birth lower the risk of problematic urinary stress, faecal, or flatal incontinence?

designWomen between 32

settingThe trial took place at 106 centres in 25 countries. POPULATION: 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.

methodsA structured self-administered questionnaire completed at 2 years postpartum.

main outcome measuresThe primary maternal outcome of the Twin Birth Study was problematic urinary stress, or fecal, or flatal incontinence at 2 years

resultsWomen 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.

conclusionsAmong 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.

fundingCanadian Institutes of Health Research (CIHR) (grant no. MCT-63164). TWEETABLE ABSTRACT: 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.

Indexed as

Cesarean SectionParturitionAdultFecal IncontinenceFemaleFlatulenceFollow-Up StudiesHumansPregnancyPregnancy, TwinPrevalenceQuality of LifeSurveys and QuestionnairesTime FactorsUrinary Incontinence, StressCaesareanrandomised trialtwin pregnancyurinary stress incontinencevaginal birth

Identifiers

PMID30007113
PMCPMC6282843
OpenAlexW2884428743

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.