Factors Associated With Self-reported Family History of Pelvic Floor Disorders

Although useful to drive prevention efforts, awareness of family history (FH) of pelvic organ prolapse (POP) or urinary incontinence (UI) may be influenced by factors other than the actual presence or absence of POP/UI in a family member. This analysis identifies demographic and clinical factors associated with positive self-reported family history (FH POP/UI +) during the first pregnancy and through 1-year postpartum (1-yr PP).

Based on self-reported FH during the third trimester, the objectives were to evaluate differences between nulliparous women with and without FH POP/UI +, identify factors associated with FH POP/UI +, and explore whether FH POP/UI + is associated with anatomic POP or moderate/severe UI at 1-yr PP.

In this secondary analysis of a prospective cohort study, multiple logistic regression models tested associations between FH POP/UI + and data collected during the third trimester (n=962), following vaginal delivery at 8 weeks postpartum (8-wk PP, n=659), and 1-yr PP (n=543).

Adjusted odds of FH POP/UI + increased with higher education level and decreased if the participant's mother delivered via cesarean at all 3 time points, increased with moderate/severe UI symptoms during pregnancy and at 1-yr PP (not assessed at 8-wk PP), and increased with enlarged genital hiatus and prepregnancy body mass index during pregnancy and at 8-wk PP, but not 1-yr PP. In exploratory analysis, FH POP/UI + was associated with moderate/severe UI ( P <0.001) but not anatomic POP ( P =0.12) at 1-yr PP.

FH POP/UI is multifactorial in nature, and future studies could investigate the relative contribution of genetics, cultural, and environmental factors to better characterize this as a risk factor for POP/UI.