Obstetric antecedents for postpartum pelvic floor dysfunction

Brian M. Casey, Joseph I. Schaffer, Steven L. Bloom, Stephen F. Heartwell, Donald D. McIntire, Kenneth J. Leveno

Research output: Contribution to journalArticle

81 Scopus citations

Abstract

Objective: The purpose of this study was to evaluate prospectively the association between selected obstetric antecedents and symptoms of pelvic floor dysfunction in primiparous women up to 7 months after childbirth. Study design: All nulliparous women who were delivered between June 1, 2000, and August 31, 2002, were eligible for a postpartum interview regarding symptoms of persistent pelvic floor dysfunction. Responses from all women who completed a survey at or before their 6-month contraceptive follow-up visit were analyzed. Obstetric antecedents to stress, urge, and anal incontinence were identified, and attributable risks for each factor were calculated. Results: During the study period, 3887 of 10,643 primiparous women (37%) returned within 219 days of delivery. Symptoms of stress and urge urinary incontinence, were significantly reduced (P < .01) in women who underwent a cesarean delivery. Symptoms of urge urinary incontinence doubled in women who underwent a forceps delivery (P = .04). Symptoms of anal incontinence were increased in women who were delivered of an infant who weighed >4000 g (P = .006) and more than doubled in those women who received oxytocin and had an episiotomy performed (P = .01). Conclusion: The likelihood of symptoms of pelvic floor dysfunction up to 7 months after delivery was greater in women who received oxytocin, who underwent a forceps delivery, who were delivered of an infant who weighed >4000 g, or who had an episiotomy performed. Women who underwent a cesarean delivery had fewer symptoms of urge and stress urinary incontinence.

Original languageEnglish (US)
Pages (from-to)1655-1662
Number of pages8
JournalAmerican journal of obstetrics and gynecology
Volume192
Issue number5 SPEC. ISS.
DOIs
StatePublished - May 2005

Keywords

  • Incontinence obstetric antecedent
  • Postpartum incontinence
  • Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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