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Variables Affecting Intra-abdominal Pressure During Lifting in the Early Postpartum Period

Hsu, Yvonne, MD*; Hitchcock, Robert, PhD; Niederauer, Stefan, BS; Nygaard, Ingrid E., MD, MS*; Shaw, Janet M., PhD; Sheng, Xiaoming, PhD§

Female Pelvic Medicine & Reconstructive Surgery: July/August 2018 - Volume 24 - Issue 4 - p 287–291
doi: 10.1097/SPV.0000000000000462
Original Articles

Objectives Intra-abdominal pressure (IAP) may contribute to pelvic floor health, although the direction and magnitude of such an effect, if any, are not yet known. Identifying individual characteristics, and in particular modifiable factors, associated with higher IAP during recovery from vaginal childbirth might serve to mitigate early pelvic floor dysfunction. The aim of this study was to identify characteristics associated with maximal IAP during lifting in postpartum primiparous women who delivered vaginally.

Methods At 6 to 10 weeks postpartum, we measured maximal IAP, assessed via an upper vaginal sensor, as participants (enrolled in an ongoing cohort study) lifted a weighted car seat (12.5 kg). We evaluated whether the following independent variables were associated with maximal IAP: age, ethnicity, body mass index, height, abdominal circumference, weight gain during pregnancy, lifting time, breath holding during lifting, lifting technique, measures of muscular fitness, and days since delivery.

Results In the 206 participants, weight, waist circumference, body mass index, and days since delivery were positively associated with mean maximal IAP during lifting, whereas IAP decreased as height increased. As the duration of the lifting task increased, mean maximal IAP during lifting also increased, but there were no associations between lifting technique or breath holding during lifting and IAP. Neither pelvic floor muscle strength nor abdominal muscle endurance was associated with IAP during lifting.

Conclusions Other than measures of body habitus and lifting duration, we did not identify modifiable factors that could mitigate maximal pressures experienced by the pelvic floor during the early postpartum period.

Other than measures of body habitus and lifting duration, we did not identify modifiable factors that could mitigate maximal pressures experienced by the pelvic floor during lifting in the early postpartum period.

From the Departments of *Obstetrics and Gynecology,

Bioengineering,

Health, Kinesiology, and Recreation, and

§Pediatrics, University of Utah, Salt Lake City, UT.

Correspondence: Ingrid E. Nygaard, MD, MS, University of Utah Department of OB/GYN, 30 North, 1900 East, Room 2B118H, Salt Lake City, UT 84132-2209. E-mail: Ingrid.nygaard@hsc.utah.edu.

The project described was supported by grant 1P01HD080629 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

The authors have declared they have no conflicts of interest.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.