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Differences in Pelvic Floor Symptoms During Pregnancy Between Hispanic and Non-Hispanic White Women

Saltzman, Hanna M. BA*; Egger, Marlene J. PhD; Bardsley, Tyler MSc; Ding, Qian MStat§; Shaw, Janet M. PhD; Nygaard, Ingrid E. MD, MS

Female Pelvic Medicine & Reconstructive Surgery: April 28, 2018 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000592
Original Article: PDF Only

Objectives This study aimed to describe and compare pelvic floor symptoms and symptom burden between nulliparous Hispanic and non-Hispanic white women in the third trimester of pregnancy and to determine, in women with stress urinary incontinence (SUI), whether bother differs between groups, adjusted for UI severity.

Methods In this cross-sectional analysis, participants completed the Epidemiology of Prolapse and Incontinence and Incontinence Severity Index questionnaires. We compared differences in symptom domains between groups using logistic regression and tested the effect of ethnicity on bother in women with SUI using linear regression.

Results The sample comprised 418 non-Hispanic white and 154 Hispanic women. Prevalence rates of symptom domains ranged from 5.0% and 7.1% for pelvic organ prolapse to 95.2% and 94.2% for overactive bladder in non-Hispanic white and Hispanic women, respectively. After adjusting age, height, weight, education, physical activity, and gestational age, non-Hispanic whites had 2.37-fold increased odds (95% confidence interval, 1.44–3.92) for defecatory dysfunction and had nonsignificant increases in other symptom domains. Non-Hispanic whites were more likely to endorse symptoms in 3 or more domains than Hispanic women (58.9% vs 40.3%, respectively; P = 0.0001). Given the same UI severity (Incontinence Severity Index), Hispanic women with SUI reported 7.5 points greater bother (Epidemiology of Prolapse and Incontinence) than non-Hispanic white women (P = 0.07).

Conclusions After adjustment, we found few differences in the prevalence of pelvic floor symptom domains between Hispanic and non-Hispanic white women, apart from defecatory dysfunction. If differences by ethnicity in other pelvic floor symptoms exist, they do not seem to originate during the first pregnancy.

From the *University of Michigan School of Medicine; Departments of †Family and Preventive Medicine and ‡Pediatrics, University of Utah School of Medicine; §Department of Surgery, Stanford University School of Medicine; ∥Department of Health, Kinesiology, and Recreation, University of Utah College of Health; and ¶Department of Obstetrics and Gynecology, University of Utah School of Medicine.

Correspondence: Ingrid Nygaard, MD, MS, Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT 84132. E-mail:

This study was supported by Grant Number 1P01HD080629 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Ingrid Nygaard receives an honorarium from Elsevier. The other authors have declared they have no conflicts of interest.

The contents of this study 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.

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