Abstract
BACKGROUND: Women's pelvic floor muscle functions can be impaired during the perinatal period, which not only affects their normal social and other quality of life and physical health, but also causes mental and psychological abnormalities. Overactive bladder (OAB) symptoms could serve as a screening trigger for broader pelvic health assessments. Then healthcare providers can better identify at-risk patients and provide improved care for those affected women. This study aimed to investigate the trends of pelvic floor conditions in perinatal women by measuring overactive bladder symptoms from pregnancy to the postpartum; and to explore related factors among women with varying characteristics by latent profile analysis. METHOD: A longitudinal cohort study was conducted from June 2020 to March 2021. A total of 700 pregnant women were enrolled at their early trimester during pregnancy. Participants completed the baseline survey and were followed up after childbirth. To measure the OAB symptoms from the second trimester of pregnancy to 6 weeks postpartum, we applied the Chinese version of the International Consultation on Incontinence Questionnaire Overactive Bladder Module. Participants' demographic information and childbirth outcomes were also collected. Latent Profile Analysis was employed to categorize women's pelvic floor conditions into a variety of subgroups. The logistic regression was performed to identify risk factors associated with pelvic floor dysfunctions in perinatal women. RESULTS: A total of 689 participants completed the study. Three characteristic categories of pelvic floor conditions among perinatal women were identified. The OAB scores increased progressively with advancing gestational age but declined gradually postpartum. Multiple regression analysis indicated that not attending the midwife clinic, below bachelor degree, vaginal delivery and pre-pregnancy overweight/obesity were all significantly associated with OAB symptoms. Compared with women in the Low Symptom During Pregnancy group (LSDP group), those in the High Symptom During Pregnancy group (HSDP group) who did not attend the midwife clinic had a lower risk of OAB symptoms (OR = 0.470; 95% CI 0.312, 0.708). Compared with the Low Symptom During Pregnancy group (LSDP group), women who did not attend the midwife clinic (OR = 3.441; 95% CI 1.540, 7.688), below bachelor degree (OR = 2.016; 95% CI 1.005, 4.042), vaginal delivery (OR = 3.954; 95% CI 1.178, 13.269) and with pre-pregnancy overweight/obesity (OR = 2.103; 95% CI 1.028, 4.303) in the Middle Symptom During Pregnancy group (MSDP group) were likely to have higher risks of OAB symptoms. Additionally, women in the Middle Symptom During Pregnancy group (MSDP group) who did not attend the midwife clinic had a higher risk of OAB symptoms in comparison to the High Symptom During Pregnancy group (HSDP group) (OR = 8.132; 95% CI 3.446, 19.190). CONCLUSIONS: Three distinct trajectories of OAB symptoms existed in Chinese perinatal women. Overall, women's pelvic floor muscle functions deteriorated as their gestational age increased, but gradually recovered after childbirth. Tailored intervention strategies should be developed to promote female pelvic floor health during the perinatal period and beyond.