title: An observational follow-up study on pelvic floor disorders to 3-5 years after delivery.
abstract: OBJECTIVE
  This study aimed to determine the prevalence of urinary incontinence (UI), fecal incontinence (FI), and pelvic organ prolapse (POP) 3-5 years after the first pregnancy and their associated risk factors.
  
  
  METHODS
  We assessed 506 women using the Pelvic Floor Distress Inventory (PFDI) and the Pelvic Floor Impact Questionnaire (PFIQ). Maternal characteristics and obstetric data were analyzed using descriptive analysis, independent sample t test, chi-squared test, and logistic regression.
  
  
  RESULTS
  The prevalence of UI, FI, and POP, respectively, at a mean of 43 months after first delivery was 40.8, 6.6, and 10.2% following vaginal delivery (VD) and 22.7, 4.5, and 4.5% following cesarean section (CS). Stress urinary incontinence (SUI) was reported by more women following VD than CS (38.7 vs 22.4%, P = 0.010). Compared with 8 weeks' postpartum, more women reported SUI at this later follow-up visit (40.1 vs 19.5%, P < 0.001), but fewer reported FI. More women who had an instrumental delivery reported symptoms of POP compared with those who had a normal VD. Higher body weight and weight gain from first trimester were risk factors of SUI [odds ratio (OR) 1.03] and urge urinary incontinence (UUI) (OR 1.18), respectively. Women who delivered vaginally had higher PFDI subscales scores.
  
  
  CONCLUSIONS
  VD increased UI risk. Higher body weight and weight gain from first trimester were risk factors for SUI and UUI, respectively. More women reported symptoms of POP following an instrumental delivery than those who had a normal VD.
authors.affiliation: Department of Obstetrics & Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong. ngkaren@cuhk.edu.hk.
authors.forename: Karen
authors.identifier: http://orcid.org/0000-0003-4165-6148
authors.initials: K
authors.lastname: Ng
authors.affiliation: Department of Obstetrics & Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Rachel Yau Kar
authors.initials: RYK
authors.lastname: Cheung
authors.affiliation: Department of Obstetrics & Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Lai Loi
authors.initials: LL
authors.lastname: Lee
authors.affiliation: Department of Obstetrics & Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Tony Kwok Hung
authors.initials: TKH
authors.lastname: Chung
authors.affiliation: Department of Obstetrics & Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Symphorosa Shing Chee
authors.initials: SSC
authors.lastname: Chan
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D059952:Pelvic Floor Disorders / Q000453:epidemiology* / Q000209:etiology; D049590:Postpartum Period; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology
keywords: Fecal incontinence; Mode of delivery; Pelvic organ prolapse; Pregnancy; Stress urinary incontinence; Urinary incontinence