Pelvic floor dysfunction (PFD) (urinary incontinence (UI), faecal incontinence (FI) and pelvic organ prolapse) in women in middle to later life is common, detrimental to health and well-being, and increasing in prevalence. There is increasing evidence to suggest that these problems may be consequences of, or are exacerbated by, pregnancy and delivery. PFD in women who have not had children is uncommon.
In 1993-94 ~8,000 women living in Aberdeen (Scotland), Birmingham (England) and Dunedin (New Zealand) took part in the ProLong study, three months after giving birth. They completed a short incontinence questionnaire at that time which revealed that 33% had UI and 8% had FI. Further questionnaires were completed at 6 years when 45%/10% of the women had UI/FI, and at 12 years when 53%/13% had UI/FI. Prolapse was measured at 12 years and found in 24% of the women.
- To understand how PFD in women who have had children changes over the life course, from childbirth through to menopause and beyond.
- To investigate associations between childbirth risk factors and pelvic floor anatomy and symptoms. In particular, are there are interactions between risk factors and the menopause?
The current study will contact the UK-based ProLong study participants again. Many of the women will now be around the age of the menopause when PFD is thought to be even more common. The women will be asked to take part in a postal questionnaire. An invitation will also be extended for the women to attend a pelvic floor examination.
Questionnaire and pelvic floor examination results will be analysed together with NHS medical records (where permission has been granted). This information will be combined with data from the women in the New Zealand arm of ProLong gathered in 2014 to report how common PFD is and how it relates to childbirth and other risk factors, particularly the menopause. The proposed research constitutes the longest ever prospective follow-up of post-natal PFD worldwide.
Findings will help inform estimates of future need for treatment and research, and ultimately improve women’s health during and after pregnancy.
Professor Suzanne Hagen
This study is funded by the Chief Scientist Office, Scottish Government Health and Social Care Directorates.