This prospective observational study involved women who were at ≥32 weeks gestational age when they delivered in a tertiary referral maternity hospital in Milan, Italy, between July and December 2014. Eligible women were scheduled for a 3-month postnatal pelvic floor clinic. The adherence rate to the pelvic floor clinic and the prevalence of pelvic floor dysfunctions at 3 months postpartum were recorded. Univariable and logistic multivariable analyses were performed to select risk factors for pelvic floor dysfunctions. Risk factors were then tested for sensitivity and specificity for 3-month postpartum pelvic floor dysfunctions.
Of 1606 eligible women, 1293 (80.5%) were included in the analysis; 685 puerperal women (53.0%) adhered to the 3-month postnatal pelvic floor clinic; pelvic floor dysfunctions were detected in 238 women (34.7%). Four elements emerged as risk factors: symptoms before pregnancy (OR 1.72, 95% CI 1.15–2.56; p = 0.008), symptoms during pregnancy (OR 2.13, 95% CI 1.49–3.06; p < 0.0001), vacuum extractor use (OR 1.62, 95% CI 1.04–2.54; p = 0.034), and severe perineal tears (OR 19.45, 95% CI 2.42–156.15; p = 0.005). The combined sensitivity and specificity for the 4 risk factors were 82% and 39%, respectively.
Internal risk factors analysis offers the potential to efficiently restrict patient selection for follow-up.