Obstetric antecedents for postpartum pelvic floor dysfunction

Am J Obstet Gynecol. 2005 May;192(5):1655-62. doi: 10.1016/j.ajog.2004.11.031.


Objective: The purpose of this study was to evaluate prospectively the association between selected obstetric antecedents and symptoms of pelvic floor dysfunction in primiparous women up to 7 months after childbirth.

Study design: All nulliparous women who were delivered between June 1, 2000, and August 31, 2002, were eligible for a postpartum interview regarding symptoms of persistent pelvic floor dysfunction. Responses from all women who completed a survey at or before their 6-month contraceptive follow-up visit were analyzed. Obstetric antecedents to stress, urge, and anal incontinence were identified, and attributable risks for each factor were calculated.

Results: During the study period, 3887 of 10,643 primiparous women (37%) returned within 219 days of delivery. Symptoms of stress and urge urinary incontinence, were significantly reduced (P < .01) in women who underwent a cesarean delivery. Symptoms of urge urinary incontinence doubled in women who underwent a forceps delivery (P = .04). Symptoms of anal incontinence were increased in women who were delivered of an infant who weighed >4000 g (P = .006) and more than doubled in those women who received oxytocin and had an episiotomy performed (P = .01).

Conclusion: The likelihood of symptoms of pelvic floor dysfunction up to 7 months after delivery was greater in women who received oxytocin, who underwent a forceps delivery, who were delivered of an infant who weighed >4000 g, or who had an episiotomy performed. Women who underwent a cesarean delivery had fewer symptoms of urge and stress urinary incontinence.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Cesarean Section / statistics & numerical data
  • Delivery, Obstetric / adverse effects*
  • Episiotomy / adverse effects
  • Fecal Incontinence / etiology*
  • Female
  • Fetal Macrosomia / complications
  • Humans
  • Likelihood Functions
  • Obstetrical Forceps / adverse effects
  • Odds Ratio
  • Oxytocin / adverse effects
  • Prospective Studies
  • Urinary Incontinence / etiology*
  • Urinary Incontinence, Stress / etiology*


  • Oxytocin