Impact of delivery method and fetal size on nocturia: An analysis of the national health and nutrition examination survey

Purpose: Pregnancy has been associated with long-term lower urinary tract symptoms such as nocturia. The purpose of this study was to explore potential associations between delivery modality and fetal size during pregnancy and the presence of nocturia. Materials and Methods: Using the National Health and Nutrition Examination Survey (NHANES) database from 2005/06-2017/18, we categorized females by status of prior delivery modalities: nulligravida, vaginal deliveries, and cesarean deliveries. Groups were weighed and case-control matched for age, race, BMI, and number of deliveries. The association of delivery modality and fetal size (>= 9 pounds or <5.5 pounds) on odds of nocturia and mean number of nighttime voids was assessed. Results: Of the 1324 females analyzed (age range 20-49 years), 378 were nulligravida, 473 had vaginal deliveries, and 473 had Cesarean deliveries. Prevalence of nocturia was 18.3% for nulligravida, 24.1% for vaginal deliveries, and 24.1% for Cesarean deliveries subgroups. Both a history of vaginal deliveries (OR = 1.42, p = 0.039) and Cesarean deliveries (OR = 1.42, p = 0.039) showed an association to nocturia, although no differences were seen between the two groups. Number of deliveries or fetal size did not show any associations to nocturia development nor differences in mean number of nighttime voids in comparing the subgroups. Conclusions: While both delivery modalities were associated with nocturia, the relationship does not differ between vaginal or Cesarean deliveries. No differences in nocturia were seen when the delivery modality groups were further sub-grouped by number of deliveries and fetal size.