Affiliation:
1. Department of Development and Regeneration, Cluster Urogenital Surgery, Biomedical Sciences KU Leuven Leuven Belgium
2. Department of Gynaecology and Obstetrics UZ Leuven Leuven Belgium
3. Department of Gynaecology and Obstetrics UZ Antwerp Edegem Belgium
4. Department of Gynaecology and Obstetrics AZ Groeninge Kortrijk Belgium
5. Research Department of Maternal Fetal Medicine, Institute for Women's Health University College London London UK
Abstract
AbstractObjectiveTo determine the prevalence of pelvic floor dysfunction (PFD) among pregnant women, their clustering and their association with body image disturbance (BID) up to 1 year postpartum.DesignMonocentric prospective cohort study.SettingUniversity Hospitals Leuven.PopulationPregnant women attending for pregnancy care, first assessed prior to 14 weeks of gestation and agreeing to follow‐up until 1 year postpartum.MethodsStandardised questionnaires reporting on PFD and BID at 12–14 and 28–32 weeks of gestation, and again at 6–8 weeks and 1 year postpartum. We calculated the prevalence of PFD, how the cases clustered and how the cases correlated with BID using a linear mixed‐model analysis. A minimum of 174 women with complete follow‐up were required.Main Outcome MeasuresThe questionnaires used were the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ‐UI SF), St. Mark's Incontinence Score (SMIS), Patient Assessment of Constipation Symptoms (PAC‐SYM), Pelvic Organ Prolapse Distress Inventory (POPDI), Pelvic Organ Prolapse/Incontinence Sexual Questionnaire IUGA Revised (PISQ‐IR) and the Body Image Disturbance Questionnaire (BIDQ).ResultsOut of 208 women, 92.8% reported one or multiple symptoms of PFD at 28–32 weeks of gestation, dropping to 73.6% by 1 year postpartum. The most common symptoms were constipation (65.3% at 28–32 weeks of gestation and 42.8% at 1 year postpartum) and urinary incontinence (56.8% at 28–32 weeks of gestation and 35.1% at 1 year postpartum). After correcting for body mass index, parity and mode of delivery, the severity of BID was associated with the ICIQ‐UI SF score (β = 0.016, range 0.007–0.024), the PAC‐SYM score (β = 0.006, range 0.002–0.011) and the POPDI score (β = 0.009, range 0.005–0.012), but not with the SMIS score (β = 0.015, range −0.001 to 0.031) or the PISQ‐IR score, in sexually active women.ConclusionsUrinary incontinence, constipation and symptoms of prolapse have a measurable impact on BID.