The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.
Pelvic floor disorders 5-10 years after vaginal or cesarean childbirth
Open accessAbstract
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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“Epidemiologic studies suggest that pelvic floor disorders are associated with childbirth, because these conditions are strongly associated with parity 5 and are more common after vaginal birth vs cesarean birth.6”
From Association of Delivery Mode With Pelvic Floor Disorders After Childbirth. (2018) · cites this paper as [5]
In the citing paper
“A positive response correlates with the presence of a vaginal bulge on examination(12) however the question has higher specificity than sensitivity for pelvic organ prolapse based on exam.(12)”
From Urinary incontinence and disability in community-dwelling women: A cross-sectional study: Urinary Incontinence and Disability in Ambulatory Women (2015) · cites this paper as [13]
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The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction
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Parity, Mode of Delivery, and Pelvic Floor Disorders
Lukacz, E. S., Lawrence, J. M., Contreras, R., Nager, C. W., & Luber, K. M. (2006) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000218096.54169.34 · Cited by 391
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Practice Bulletin No. 183: postpartum hemorrhage
(2017) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000002351 · Cited by 1,406
Risk factors for pelvic organ prolapse and its recurrence: a systematic review
Vergeldt, T. F. M., Weemhoff, M., IntHout, J., & Kluivers, K. B. (2015) · International Urogynecology Journal · doi:10.1007/s00192-015-2695-8 · Cited by 572
Lukacz, E. S., Santiago‐Lastra, Y., Albo, M., & Brubaker, L. T. (2017) · JAMA · doi:10.1001/jama.2017.12137 · Cited by 560
Association of Delivery Mode With Pelvic Floor Disorders After Childbirth.
Blomquist, J. L., Muñoz, A., Carroll, M., & Handa, V. L. (2018) · JAMA · doi:10.1001/jama.2018.18315 · Cited by 328
Self-citationGyhagen, M., Bullarbo, M., Nielsen, T., & Milsom, I. (2012) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.12020 · Cited by 308
Metadata
- Authors
- Handa, V. L., Blomquist, J. L., Knoepp, L. R., Hoskey, K. A., McDermott, K. C., & Muñoz, A.
- Affiliations
- Greater Baltimore Medical Center (US)
- Venue
- Obstetrics & Gynecology
- Published
- 2011-10
- Volume
- 118
- Issue
- 4
- Pages
- 777-784
- ISSN
- 0029-7844 (ISSN-L)
- 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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