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

Abstract

Objectives To determine factors associated with decreased pelvic floor strength (PFS) after the first vaginal delivery 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, 3D ultrasound and measurement of pelvic floor strength (PFS) in the third trimester and repeated at 4 weeks-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 (SD, 4.8). There were 46 (66%) subjects with a vaginal delivery (VD) and 24 (34%) with a cesarean delivery (CD) who labored. Decreased PFS was observed more frequently in the VD group compared to the CD 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 age 25-29 (RR=2.80, 95% CI 1.03-7.57) and >=30 (RR=2.53, 95% CI 0.93-6.86)) were over 2.5 times more likely to have decreased postpartum PFS compared to women < 25 yo. Conclusions In this population, women age 25 and older were more than twice as likely to have a decrease in postpartum PFS.

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