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The Epidemiology of Pelvic Floor Disorders and Childbirth: An Update

Jennifer L Hallock1, Victoria L Handa2

  • 1Female Pelvic Medicine & Reconstructive Surgery, Johns Hopkins School of Medicine, 4940 Eastern Avenue, 301 Building, Suite 3200, Baltimore, MD 21224, USA.

Obstetrics and Gynecology Clinics of North America
|February 17, 2016
PubMed

Insights

Childbirth, particularly vaginal delivery, increases the risk of pelvic floor disorders (PFDs) like prolapse and incontinence. Factors such as genetics, age, and obesity also contribute to PFD development over a lifespan.

Area of Science:

  • Reproductive medicine
  • Pelvic floor disorders research
  • Lifespan health studies

Background:

  • Pelvic floor disorders (PFDs) encompass conditions like prolapse and incontinence.
  • Childbirth is a known risk factor, but specific contributing factors require further elucidation.
  • A comprehensive lifespan model is needed to understand PFD etiology.

Purpose of the Study:

  • To investigate risk factors for pelvic floor disorders (PFDs) using a lifespan model.
  • To determine the specific impact of childbirth on the development of PFDs.
  • To identify predisposing, inciting, and intervening factors in PFD development.

Main Methods:

  • Development and application of a lifespan model for analyzing PFD risk factors.
  • Categorization of risk factors into predisposing (genetics, race), inciting (obstetric events), and intervening (age, obesity) phases.
  • Comparative analysis of PFD prevalence based on delivery mode.

Main Results:

  • Vaginal delivery is associated with a higher incidence of prolapse and urinary incontinence (UI).
  • The risk of fecal incontinence (FI) is also elevated following vaginal delivery, though to a lesser extent than prolapse and UI.
  • Genetic predisposition, race, age, and obesity are significant factors throughout a woman's lifespan.

Conclusions:

  • Childbirth, especially vaginal delivery, is a critical factor in the development of PFDs.
  • PFDs result from a complex interplay of genetic, obstetric, and lifestyle factors across the lifespan.
  • Understanding these multifactorial risks can inform prevention and management strategies for PFDs.

Keywords:
Cesarean sectionChildbirthFecal incontinencePelvic floor disordersPelvic organ prolapseUrinary incontinenceVaginal delivery

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