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Pelvic Floor Support and Symptoms 1 Year Postpartum in Relation to Excess Body Habitus Before, During and After First

Xiaoming Sheng1, Jie Wang2, Janet M Shaw3

  • 1From the College of Nursing, University of Utah.

Female Pelvic Medicine & Reconstructive Surgery
|March 2, 2022
PubMed

Insights

Obesity during pregnancy and postpartum is linked to urinary incontinence, but not other pelvic floor issues. Body mass index (BMI) at one year postpartum is a strong predictor of these symptoms.

Area of Science:

  • Obstetrics and Gynecology
  • Pelvic Floor Disorders
  • Maternal Health

Background:

  • Obesity is a potential modifiable risk factor for pelvic floor disorders.
  • Understanding the impact of weight changes during and after pregnancy on pelvic floor health is crucial.

Purpose of the Study:

  • To determine associations between body mass index (BMI), weight changes, and cumulative excess BMI from prepregnancy to one year postpartum.
  • To assess the impact on pelvic floor support and symptoms one year after the first vaginal birth.

Main Methods:

  • A study of 645 primiparous women who had vaginal births.
  • Assessment of pelvic floor support, symptoms, and BMI at multiple timepoints: third trimester, 5-10 weeks postpartum, and one year postpartum.
  • Multivariable models used to analyze associations between BMI, weight gain, weight retention, and pelvic floor outcomes.

Main Results:

  • Body mass index (BMI) was not associated with anatomic support, overall symptom burden, overactive bladder, anal incontinence, or constipation.
  • Higher BMI at all measured timepoints was positively associated with stress urinary incontinence (SUI) and moderate/severe urinary incontinence (UI).
  • BMI at one year postpartum (BMI1year) was the most predictive of SUI and moderate/severe UI.

Conclusions:

  • Pregnancy and postpartum BMI trajectory was not associated with pelvic floor outcomes, except for urinary incontinence (UI).
  • One-year postpartum BMI adequately captures the risk for UI symptoms.
  • While cumulative excess BMI showed a slight predictive advantage, BMI at one year postpartum is a key indicator for UI risk.
Abstract

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