Clinical Edge

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Childbirth Delivery Mode & Pelvic Floor Disorders

JAMA; 2018 Dec 18; Blomquist, Muñoz, et al

The risk of pelvic floor disorders varies by delivery mode after childbirth, with cesarean delivery presenting a lower risk compared to vaginal delivery, a recent study found. In the cohort of 1,528 women, researchers described the incidence of pelvic floor disorders after childbirth and identified maternal and obstetrical characteristics associated with patterns of incidence 1 to 2 decades after delivery. Participants were categorized into the following mode of delivery groups: cesarean birth, spontaneous vaginal birth (≥1 spontaneous vaginal delivery and no operative vaginal deliveries), or operative vaginal birth (≥operative vaginal delivery). Among the findings:

  • Compared with spontaneous vaginal delivery, cesarean delivery was associated with significantly lower hazard for stress urinary incontinence, overactive bladder, and pelvic organ prolapse.
  • Operative vaginal delivery was associated with significantly higher hazard of anal incontinence and pelvic organ prolapse.
  • A larger genital hiatus size was associated with increased risk of pelvic organ prolapse independent of delivery mode.

Citation:

Blomquist JL, Muñoz A, Carroll M, Handa VL. Association of delivery mode with pelvic floor disorders after childbirth. JAMA. 2018;320(23):2438–2447. doi:10.1001/jama.2018.18315.