Risk Factors of Pelvic Floor Dysfunction in Postpartum Period: a Cross-Section Study

Abstract

Introduction: Pelvic floor dysfunction (PFD) is most commonly dysfunctions in women, it has been reported to affect 23% to 49% of women according to an epidemiological report. PFDs have many consequences, such as pain, embarrassment, social isolation, and a decreased quality of life (QOL). Thus, this study aims to understand which factors are associated with the development of postpartum pelvic floor dysfunction and determine the degree of such dysfunctions to provide theoretical and data support for clinical diagnosis and treatment of this disorder. Method: Puerperal women were recruited between September to November of 2021 by an online survey platform called WenjuanXing. And the demographic characteristics and PFDs related questionnaire were be collected and analyzed. Multivariate logistic regression analyses were conducted to identify the risk factors of postpartum PFDs in postpartum women. Result: A total of 1226 participants were included, the incidence of urinary incontinence (UI), pelvic organ prolapse (POP) and anal incontinence (AI) was 79.6%, 70.7% and 67.4%, respectively. Multivariate logistic regression analyses shown that body mass index (BMI) more than 28 (OR: 2.591, 95% CI: 1.016-6.607), gestational diabetes (OR: 1.541, 95% CI: 1.011-2.348, P=0.044), prenatal incontinence (OR: 2.63, 95% CI: 0.405-0.982), vaginal delivery (OR: 1.521, 95% CI: 0.35-0.774), episiotomy (OR: 1.595, 95% CI: 1.093-2.326) were the risk factors of postpartum UI. BMI more than 28 (OR: 2.337, 95% CI: 1.086-5.029), smoking in pregnancy (OR: 1.434, 95% CI: 0.241-0.78), vaginal delivery (OR: 1.663, 95% CI: 0.473-0.93) were the risk factors of the POP, however, BMI less than 18.5(OR: 546, 95% CI: 0.337-0.885) was considered as a protective factor for POP in statistical methods. BMI less than 18.5 (OR: 0.555, 95% CI: 0.344-0.895) was only the protective factor of Colorectal-Anal Distress Inventory (CRADI). Conclusion: According to our data, we conclude that the BMI >28, gestational diabetes, prenatal incontinence, vaginal delivery, and episiotomy are risk factors for postpartum UI. In addition to the above risk factors, smoking has also been found to be a risk factor for POP. However, we found no risk factors for AI. Additionally, we found that BMI <18.5 is a protective factor of AI and POP.