The association between maternal age at first delivery and risk of obstetric trauma

Can pelvic floor trauma be predicted antenatally?

“…In this study of more than 800 women, we have confirmed findings of previous studies showing an association between maternal age and levator avulsion (see Figure ) . It seems that advanced maternal age at the time of first delivery carries not only an increased risk of pregnancy complications, for example, gestational diabetes, preeclampsia and stillbirth, but also an increased risk of pelvic floor trauma . Changes in the biomechanical properties of pelvic floor connective tissues with age may explain the association, as connective tissue may become less elastic and more susceptible to trauma .…”

“…This is likely due to the smaller study size. Other risk factors shown to be associated with levator trauma include increasing maternal age , smaller AP diameter at rest and on Valsalva on transperineal ultrasound and increasing head circumference and birthweight of the newborn . However, findings have been inconsistent across studies and the clinical usefulness of these parameters is limited, especially in the case of estimated fetal weight using antenatal ultrasound.…”

A comparative study of obstetric anal sphincter injuries in vaginal deliveries of twins and singleton pregnancies

“…This is in agreement with previous studies demonstrating it to be one of major risk factors for OASIS . There is evidence that maternal age, particularly at first delivery, is more significant . In this study, the mean difference in age between the groups was almost 2 years.…”

“…4,18 There is evidence that maternal age, particularly at first delivery, is more significant. 19 In this study, the mean difference in age between the groups was almost 2 years. Greater maternal age is anticipated in twin pregnancies given that many women are delaying pregnancy for later on in life and having to resort to assisted reproductive technology, accounting for the rise in multiple pregnancies.…”

Levator ani muscle coactivation at term is associated with longer second stage of labor in nulliparous women

“…Pregnancy and delivery are associated with an increased risk of pelvic floor dysfunction [1][2][3] . With the introduction of imaging techniques, especially transperineal ultrasound (TPU), our understanding of the relationship between vaginal delivery and pelvic floor dysfunction has improved [4][5][6][7][8] . Over the past few years, much effort has been spent diagnosing and identifying risk factors for pelvic floor muscle injury, which seems to be the connection between vaginal delivery and the development of prolapse and pelvic floor dysfunction [9][10][11][12][13][14][15][16][17][18] .…”