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Increasing Age Is a Risk Factor for Decreased Postpartum Pelvic Floor Strength

Quiroz, Lieschen H. MD; Pickett, Stephanie D. MD, MS; Peck, Jennifer D. PhD; Rostaminia, Ghazaleh MD; Stone, Daniel E. MD; Shobeiri, S. Abbas MD

Female Pelvic Medicine & Reconstructive Surgery: March/April 2017 - Volume 23 - Issue 2 - p 136–140
doi: 10.1097/SPV.0000000000000376
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Objectives This study aimed to determine factors associated with decreased pelvic floor strength (PFS) after the first vaginal delivery (VD) in a cohort of low-risk women.

Methods This is a secondary analysis of a prospective study examining the risk of pelvic floor injury in a cohort of primiparous women. All recruited participants underwent an examination, three-dimensional ultrasound and measurement of PFS in the third trimester and repeated at 4 weeks to 6 months postpartum using a perineometer.

Results There were 84 women recruited for the study, and 70 completed the postpartum assessment. Average age was 28.4 years (standard deviation, 4.8). There were 46 (66%) subjects with a VD and 24 (34%) with a cesarean delivery who labored. Decreased PFS was observed more frequently in the VD group compared with the cesarean delivery group (68% vs 42%, P = 0.03).

In modified Poisson regression models controlling for mode of delivery and time of postpartum assessment, women who were aged 25 to 29 years (risk ratio = 2.80, 95% confidence interval, 1.03–7.57) and 30 years and older (risk ratio = 2.53, 95% confidence interval, 0.93–6.86) were over 2.5 times more likely to have decreased postpartum PFS compared with women younger than 25 years.

Conclusions In this population, women aged 25 years and older were more than twice as likely to have a decrease in postpartum PFS.

From the *Division of Female Pelvic Medicine and Reconstructive Surgery, University of Oklahoma Health Sciences Center; †Obstetrics and Gynecology, Mercy Hospital; ‡Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK; and §Obstetrics and Gynecology, INOVA, Fairfax, VA.

Reprints: Lieschen H. Quiroz, MD, Division of Female Pelvic Medicine and Reconstructive Surgery, University of Oklahoma Health Sciences Center, 920 S.L. Young, WP 2430, Oklahoma City, OK 73104. E-mail:

The authors have declared they have no conflicts of interest.

This study was supported by the National Institutes of Health, National Institute of General Medical Sciences grant no. 1 U54GM104938 and by The American College of Obstetricians and Gynecologists/Kenneth Gottesfeld-Charles Hohler Memorial Foundation Research Award in Ultrasound.

Accepted as an oral presentation at the American Urogynecologic Association Annual Scientific Meeting 2016 in Denver, Colorado.

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