Cited by 345Pelvic floor disorders treatmentsMaternal and Perinatal Health InterventionsPregnancy-related medical research

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Pelvic floor disorders 5-10 years after vaginal or cesarean childbirth

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Handa, Victoria L., Blomquist, Joan L., Knoepp, Leise R., Hoskey, Kay A., McDermott, Kelly C., Muñoz, Alvaro·2011·Obstetrics & Gynecology

DOI 10.1097/aog.0b013e3182267f2fPMC PMC3178744

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Abstract

OBJECTIVE: To estimate differences in pelvic floor disorders by mode of delivery. METHODS: We recruited 1,011 women for a longitudinal cohort study 5-10 years after first delivery. Using hospital records, we classified each birth as: cesarean without labor, cesarean during active labor, cesarean after complete cervical dilation, spontaneous vaginal birth, or operative vaginal birth. At enrollment, stress incontinence, overactive bladder, anal incontinence, and prolapse symptoms were assessed with a validated questionnaire. Pelvic organ support was assessed using the Pelvic Organ Prolapse Quantification system. Logistic regression analysis was used to estimate the relative odds of each pelvic floor disorder by obstetric history, adjusting for relevant confounders. RESULTS: Compared with cesarean without labor, spontaneous vaginal birth was associated with a significantly greater odds of stress incontinence (odds ratio [OR] 2.9, 95% confidence interval [CI] 1.5-5.5) and prolapse to or beyond the hymen (OR 5.6, 95% CI 2.2-14.7). Operative vaginal birth significantly increased the odds for all pelvic floor disorders, especially prolapse (OR 7.5, 95% CI 2.7-20.9). These results suggest that 6.8 additional operative births or 8.9 spontaneous vaginal births, relative to cesarean births, would lead to one additional case of prolapse. Among women delivering exclusively by cesarean, neither active labor nor complete cervical dilation increased the odds for any pelvic floor disorder considered, although the study had less than 80% power to detect a doubling of the odds with these exposures. CONCLUSION: Although spontaneous vaginal delivery was significantly associated with stress incontinence and prolapse, the most dramatic risk was associated with operative vaginal birth. LEVEL OF EVIDENCE: II.

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Authors: Handa, V. L., Blomquist, J. L., Knoepp, L. R., Hoskey, K. A., McDermott, K. C., & Muñoz, A.
Affiliations: Greater Baltimore Medical Center (US)
ORCID: Handa, Victoria L.
Blomquist, Joan L.
Venue: Obstetrics & Gynecology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2011-10
Volume: 118
Issue: 4
Pages: 777-784
ISSN: 0029-7844 (ISSN-L)
DOI: 10.1097/aog.0b013e3182267f2f
PMC: PMC3178744
OpenAlex: W2155715307
Cited by: 345
References: 30
Citations by year: 2026: 13 · 2025: 23 · 2024: 38 · 2023: 20 · 2022: 19 · 2021: 23 · 2020: 34 · 2019: 23 · 2018: 23 · 2017: 22 · 2016: 23 · 2015: 24 · 2014: 17 · 2013: 12 · 2012: 25
FWCI: 13.51
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD056275)
Topics: Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy-related medical research
Keywords: pelvic floor dysfunction, mode of delivery, cesarean section, vaginal delivery, instrumental delivery, stress urinary incontinence, overactive bladder, anal incontinence, pelvic organ prolapse, pelvic organ support, postpartum women
MeSH terms: Adult, Cesarean Section, Fecal Incontinence, Female, Humans, Obstetric Labor Complications, Longitudinal Studies, Pregnancy, Prospective Studies, Surveys and Questionnaires, Urinary Incontinence, Stress, Pelvic Floor, Parturition, Urinary Bladder, Overactive, Pelvic Organ Prolapse

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Pelvic floor disorders 5-10 years after vaginal or cesarean childbirth

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