Pelvic floor dysfunction in postpartum women: A cross-sectional study

PLoS One. 2024 Oct 3;19(10):e0308563. doi: 10.1371/journal.pone.0308563. eCollection 2024.

Abstract

Background: Pelvic floor dysfunction (PFD) is a disease of weakened pelvic floor support tissues, leading to changes in the pelvic organ position and function of pelvic organs, with long-term effects on women. This study aimed to assess pelvic floor function using electrophysiology and clinical symptoms, exploring the risk factors for PFD one month postpartum.

Methods: This cross-sectional study included 845 women from postpartum outpatient clinic of Nantong Affiliated Hospital from August 2019 to October 2021. Pelvic floor muscle strength was evaluated via pelvic floor surface electromyography. Clinical symptoms (urinary incontinence (UI) and pelvic organ prolapse) were diagnosed by gynecologists. Sociodemographic, pregnancy, and obstetrical data were obtained from self-reported questionnaires and electronic records.

Results: The study identified maternal age, parity, immigrant status, and economic income as factors were related to PFD. Gestational constipation increased the risk of abnormal resting muscle strength (OR:1.553, 95%CI: 1.022-2.359). Cesarean delivery was associated with higher rates of abnormal resting muscle strength than vaginal delivery (post-resting stage: OR, 2.712; 95% CI, 1.189-6.185), but a decreased incidence of UI (OR: 0.302; 95% CI, 0.117-0.782). Increased gestational weight gain was correlated with a greater risk of developing UI (OR:1.030, 95%CI: 1.002-1.058). Women with vaginal inflammation faced a higher risk of abnormal fast-twitch muscle (OR: 2.311, 95%CI: 1.125-4.748).

Conclusions: In addition to uncontrollable factors like mode of delivery, age, and parity, interventions targeting weight gain and constipation during pregnancy and vaginal flora could mitigate the risks of PFD. Educational programs for pregnant women should emphasize a proper diet and lifestyle. For women with vaginal inflammation, clinical treatment should be carried out as soon as possible to avoid further aggravating the damage to the pelvic floor muscles.

MeSH terms

  • Adult
  • Cesarean Section / adverse effects
  • Constipation / epidemiology
  • Constipation / physiopathology
  • Cross-Sectional Studies
  • Electromyography
  • Female
  • Humans
  • Muscle Strength
  • Pelvic Floor Disorders* / epidemiology
  • Pelvic Floor Disorders* / etiology
  • Pelvic Floor Disorders* / physiopathology
  • Pelvic Floor* / physiopathology
  • Pelvic Organ Prolapse / epidemiology
  • Pelvic Organ Prolapse / physiopathology
  • Postpartum Period*
  • Pregnancy
  • Risk Factors
  • Urinary Incontinence* / epidemiology
  • Urinary Incontinence* / etiology
  • Urinary Incontinence* / physiopathology

Grants and funding

This work was supported by the National Natural Science Foundation of China [grant numbers [72274100] and Nantong Municipal Health Commission [grant numbers QN2023002]. This was a government funded project. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.