TY - JOUR
T1 - Pelvic muscle strength after childbirth
AU - Friedman, Sarah
AU - Blomquist, Joan L.
AU - Nugent, Joann M.
AU - McDermott, Kelly C.
AU - Muñoz, Alvaro
AU - Handa, Victoria L.
PY - 2012/11
Y1 - 2012/11
N2 - Objective: The objective was to estimate the effect of vaginal childbirth and other obstetric exposures on pelvic muscle strength 6-11 years after delivery and to investigate the relationship between pelvic muscle strength and pelvic floor disorders. Methods: Among 666 parous women, pelvic muscle strength was measured with a perineometer 6-11 years after delivery. Obstetric exposures were classified by review of hospital records. Pelvic floor outcomes, including 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. Kruskal-Wallis tests were used to estimate the univariable associations of obstetric exposures and pelvic floor outcomes with peak muscle strength. Stepwise multivariable linear regression models were used to estimate the association between obstetric exposures and muscle strength. Results: In comparison with women who delivered all of their children by cesarean, peak muscle strength and duration of contraction were reduced among women with a history of vaginal delivery (39 compared with 29 cm H2O, P<.001). Pelvic muscle strength was further reduced after history of forceps delivery (17 cm H2O, P<.001). After vaginal delivery, reduced pelvic muscle strength was associated with symptoms of anal incontinence (P=.028) and pelvic organ prolapse on examination (P=.025); these associations were not observed among those who had delivered exclusively by cesarean. Conclusion: Pelvic muscle strength almost a decade after childbirth is affected by vaginal delivery and by forceps delivery. Although statistically significant, some of the differences observed were small in magnitude.
AB - Objective: The objective was to estimate the effect of vaginal childbirth and other obstetric exposures on pelvic muscle strength 6-11 years after delivery and to investigate the relationship between pelvic muscle strength and pelvic floor disorders. Methods: Among 666 parous women, pelvic muscle strength was measured with a perineometer 6-11 years after delivery. Obstetric exposures were classified by review of hospital records. Pelvic floor outcomes, including 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. Kruskal-Wallis tests were used to estimate the univariable associations of obstetric exposures and pelvic floor outcomes with peak muscle strength. Stepwise multivariable linear regression models were used to estimate the association between obstetric exposures and muscle strength. Results: In comparison with women who delivered all of their children by cesarean, peak muscle strength and duration of contraction were reduced among women with a history of vaginal delivery (39 compared with 29 cm H2O, P<.001). Pelvic muscle strength was further reduced after history of forceps delivery (17 cm H2O, P<.001). After vaginal delivery, reduced pelvic muscle strength was associated with symptoms of anal incontinence (P=.028) and pelvic organ prolapse on examination (P=.025); these associations were not observed among those who had delivered exclusively by cesarean. Conclusion: Pelvic muscle strength almost a decade after childbirth is affected by vaginal delivery and by forceps delivery. Although statistically significant, some of the differences observed were small in magnitude.
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U2 - 10.1097/AOG.0b013e318265de39
DO - 10.1097/AOG.0b013e318265de39
M3 - Article
C2 - 23090518
AN - SCOPUS:84868197076
SN - 0029-7844
VL - 120
SP - 1021
EP - 1028
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 5
ER -