First-born birth weight predicts pelvic organ prolapse

  • Martinho N & al.
  • Int Urogynecol J
  • 8 Feb 2019

  • curated by Craig Hicks
  • Clinical Essentials
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Takeaway

  • The birth weight of a woman’s first vaginally born baby is associated with levator avulsion and eventual pelvic organ prolapse (POP).

Why this matters

  • Birth weight joins other major risk factors for levator trauma such as first vaginal delivery, advanced maternal age at first delivery (>35 years), and use of forceps.

Study design

  • Researchers studied women with at least 2 vaginal deliveries (N=1125) who underwent a physician-directed interview, followed by clinical examination and 4D translabial ultrasound.
  • They tested for associations between birth weights of the first and largest vaginally born baby and avulsion or signs and symptoms of prolapse.
  • Funding: author support from the Foundation of Research Support of the State of Sao Paulo, Brazil.

Key results

  • If the first vaginally born baby was also the heaviest, this was a significant risk factor for levator avulsion: OR, 1.36 (P =.03).
  • The first vaginally born baby’s birth weight was as predictive for avulsion as the birth weight of subsequent babies, even after adjusting for maternal age at first delivery and use of forceps (area under the curve, 0.634).

Limitations

  • Obstetric data, including birth weight, were patient-reported.

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