Joint hypermobility, obstetrical outcomes, and pelvic floor disorders.
OBJECTIVE
Benign joint hypermobility syndrome may be a risk factor for pelvic floor disorders. It is unknown whether hypermobility impacts the progress of childbirth, a known risk factor for pelvic floor disorders. Our objective was to investigate the association between joint hypermobility syndrome, obstetrical outcomes, and pelvic floor disorders. Our hypotheses were: (1) women with joint hypermobility are less likely to experience operative delivery and prolonged second-stage labor; and (2) pelvic floor disorders are associated with benign hypermobility syndrome, controlling for obstetrical history.


METHODS
Joint hypermobility was measured in 587 parous women (participants in a longitudinal cohort study of pelvic floor disorders after childbirth). Their obstetrical histories were obtained from review of hospital records. Pelvic floor disorders were assessed using validated questionnaires and a structured examination for prolapse. Joint hypermobility and pelvic floor disorders were evaluated at enrollment (5-10 years after first delivery). We compared obstetrical outcomes and pelvic floor disorders between women with and without joint hypermobility, defined as a Beighton score ≥ 4.


RESULTS
Hypermobility was diagnosed in 46 women (7.8 %) and was associated with decreased odds of cesarean after complete cervical dilation or operative vaginal delivery [odds ratio (OR)=0.51; 95 % confidence interval (CI):0.27-0.95]. Anal sphincter laceration was unlikely to occur in women with hypermobility (OR=0.19; 95 % CI 0.04-0.80). However, hypermobility was not associated with any pelvic floor disorder considered.


CONCLUSIONS
Benign joint hypermobility syndrome may facilitate spontaneous vaginal birth but does not appear to be a risk factor for pelvic floor disorders in the first decade after childbirth.
Department of Obstetrics and Gynecology, Ochsner Medical Center, New Orleans, LA, USA.
Leise R
LR
Knoepp
Kelly C
KC
McDermott
Alvaro
A
Muñoz
Joan L
JL
Blomquist
Victoria L
VL
Handa
D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications*; D007743:Labor, Obstetric / Q000502:physiology*; D008396:Maryland / Q000453:epidemiology; D059952:Pelvic Floor Disorders / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy