Determinants of pelvic floor muscle strength and dysfunction in postpartum women: an exploratory cross- sectional study.

Abstract

Objective. The aim of this study was to identify determinants that increase the risk of pelvic floor dysfunction (PFD) among early postpartum women receiving care for PFD at a tertiary hospital in the North of England. Materials and methods. A retrospective cross- sectional study was conducted in a National Health Service trust. The study participants were women < 6 months postpartum who were referred to pelvic health physiotherapy with PFD symptoms between 1 June 2021 and 1 June 2022. The information collected included soci-odemographic data, type of delivery, the number and type of PFD symptoms, and pelvic floor muscle (PFM) strength. The main outcome measures were the number and type of PFD symptoms (bladder, bowel, prolapse or sexual dysfunction), and PFM strength. Results. One hundred and sixty- six postpartum physiotherapy records were included. Forceps delivery was identified as the type of delivery that was most associated with PFD symptoms [2.45 +/- 0.88 versus 1.85 +/- 0.81; P <= 0.001; confidence interval (CI) = 0.28-0.92] and PFM weakness (2.15 +/- 0.73 versus 2.5 +/- 0.91; P = 0.02; CI = 0.04-0.66) compared to spontaneous vaginal delivery. Women aged >= 35 years were also found to have a higher odds ratio of developing PFD compared to women under 35 years of age (odds ratio = 1.079; 95% CI = 1.01-1.15). Conclusions. Forceps delivery and a maternal age of >= 35 years are associated with a greater severity of PFD symptoms and weaker PFM strength in the early postpartum population compared to ventouse and spontaneous vaginal delivery. These findings suggest that there is a need to reduce the use of forceps and increase awareness of PFD.