Assessment of Risk Factors Associated With Postpartum Pelvic Floor Dysfunction and Opportunities for Prevention
Abstract
Background: Postpartum pelvic floor dysfunction (PFD) is a common maternal health problem that includes urinary incontinence, pelvic organ prolapse, sexual dysfunction, and chronic pelvic pain. Multiple obstetric and maternal factors contribute to its development. Objective: To assess the risk factors associated with postpartum pelvic floor dysfunction and identify opportunities for prevention among postpartum women. Methods: This cross-sectional analytical study was conducted at DHQ Hospital Mardan from June 2024 to June 2025 including 220 postpartum women evaluated within 12 months after delivery. Results: The mean age of participants was 29.8 ± 5.6 years, and the mean BMI was 27.1 ± 4.2 kg/m². Vaginal delivery was reported in 156 (70.9%) women. Overall, 112 (50.9%) participants experienced at least one form of pelvic floor dysfunction. Urinary incontinence was the most common symptom, affecting 84 (38.2%) women. Women with pelvic floor dysfunction had significantly higher age and BMI. Vaginal delivery (aOR 3.18; p=0.001), BMI >30 kg/m² (aOR 2.74; p=0.005), instrumental delivery (aOR 2.41; p=0.02), prolonged labor (aOR 2.63; p=0.01), and birth weight >3.5 kg (aOR 2.29; p=0.02) were significant predictors of pelvic floor dysfunction. Pelvic floor exercises showed a protective effect (aOR 0.42; p=0.01). Conclusion: Postpartum pelvic floor dysfunction is strongly associated with obstetric and maternal risk factors. Preventive strategies including pelvic floor rehabilitation, weight management, and improved obstetric care may reduce postpartum pelvic floor morbidity.