title: Increasing Age Is a Risk Factor for Decreased Postpartum Pelvic Floor Strength.
abstract: This study aimed to determine factors associated with decreased pelvic floor strength (PFS) after the first vaginal delivery (VD) in a cohort of low-risk women.
  
  
  
  This is a secondary analysis of a prospective study examining the risk of pelvic floor injury in a cohort of primiparous women. All recruited participants underwent an examination, three-dimensional ultrasound and measurement of PFS in the third trimester and repeated at 4 weeks to 6 months postpartum using a perineometer.
  
  
  
  There were 84 women recruited for the study, and 70 completed the postpartum assessment. Average age was 28.4 years (standard deviation, 4.8). There were 46 (66%) subjects with a VD and 24 (34%) with a cesarean delivery who labored. Decreased PFS was observed more frequently in the VD group compared with the cesarean delivery group (68% vs 42%, P = 0.03).In modified Poisson regression models controlling for mode of delivery and time of postpartum assessment, women who were aged 25 to 29 years (risk ratio = 2.80, 95% confidence interval, 1.03-7.57) and 30 years and older (risk ratio = 2.53, 95% confidence interval, 0.93-6.86) were over 2.5 times more likely to have decreased postpartum PFS compared with women younger than 25 years.
  
  
  
  In this population, women aged 25 years and older were more than twice as likely to have a decrease in postpartum PFS.
authors.affiliation: From the *Division of Female Pelvic Medicine and Reconstructive Surgery, University of Oklahoma Health Sciences Center; †Obstetrics and Gynecology, Mercy Hospital; ‡Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK; and §Obstetrics and Gynecology, INOVA, Fairfax, VA.
authors.forename: Lieschen H
authors.initials: LH
authors.lastname: Quiroz
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Pickett
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Peck
authors.forename: Ghazaleh
authors.initials: G
authors.lastname: Rostaminia
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Stone
authors.forename: S Abbas
authors.initials: SA
authors.lastname: Shobeiri
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D020073:Gravidity; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D007744:Obstetric Labor Complications / Q000209:etiology / Q000503:physiopathology; D017773:Pelvic Floor / Q000293:injuries / Q000502:physiology; D059952:Pelvic Floor Disorders / Q000209:etiology / Q000503:physiopathology*; D011181:Postnatal Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000503:physiopathology*; D011263:Pregnancy Trimester, Third; D011295:Prenatal Care; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D055815:Young Adult