Risk Factors and Nomogram for Postpartum Myofascial Pelvic Pain: A Prospective Cohort Study

Area of Science:

• Obstetrics and Gynecology
• Pelvic Health
• Postpartum Care

Background:

• Myofascial pelvic pain (MFPP) is a common yet frequently overlooked postpartum complication.
• Early identification of at-risk individuals is essential for timely intervention and rehabilitation.

Purpose of the Study:

• To identify key risk factors associated with postpartum MFPP.
• To develop a predictive nomogram for early risk stratification of postpartum MFPP.

Main Methods:

• A prospective cohort study involving 671 women was conducted.
• Risk factors were identified using multivariable logistic regression and a predictive nomogram was constructed.
• Participants were divided into training (n=505) and validation (n=166) sets.

Main Results:

• The incidence of postpartum MFPP was 12.9% (training) and 11.4% (validation).
• Independent risk factors identified include neonatal birth weight ≥4 kg, vaginal laceration, parity ≥3, and history of dyspareunia.
• The nomogram demonstrated moderate discriminative ability with an AUC of 0.681 (training) and 0.656 (validation).

Conclusions:

• Macrosomia, vaginal laceration, grand multiparity, and history of dyspareunia are significantly associated with postpartum MFPP.
• The developed nomogram shows potential as a preliminary tool for early risk stratification.
• Further multicenter validation is recommended prior to widespread clinical implementation.