Twenty years after childbirth, the risk of symptomatic pelvic organ prolapse (sPOP) is increased after a single vaginal delivery versus cesarean section, according to a study published online in BJOG: An International Journal of Obstetrics and Gynaecology.
Maria Gyhagen, of the Sahlgrenska Academy at Gothenburg University in Sweden, and colleagues examined the prevalence and risk factors for sPOP and concomitant urinary incontinence 20 years after one cesarean section or vaginal delivery. A total of 5,236 singleton primiparae with a birth in 1985 to 1988 with no further births were surveyed using validated questionnaires.
The researchers found that there was an increased prevalence of sPOP after vaginal delivery compared with cesarean section (14.6% vs. 6.3%),a difference that translated into a 2.5 times increased risk for sPOP. The study found no increase after acute versus elective cesarean section. Compared with spontaneous vaginal delivery, researchers observed no increased risk of sPOP with episiotomy, vacuum extraction, and second-degree or more laceration. Each unit increase of current body mass index and each 100 g increase in birth weight was associated with a significant 3% increase in sPOP risk. The prevalence of sPOP was doubled for mothers 160 cm or less in height who delivered a child weighing 4,000 g or greater, compared with short mothers who delivered an infant weighing less than 4,000 g (24.2% vs. 13.4%), or a twofold increased risk of sPOP. Compared with women without prolapse, women with sPOP more often had urinary incontinence and urinary incontinence for more than 10 years.
“The prevalence of sPOP was doubled after vaginal delivery compared with caesarean section, two decades after one birth,” the authors write.