Relationship Between Vaginal Delivery And Pelvic Floor Dysfunction: A Systematic Review And Meta-Analysis

Background: Pelvic floor dysfunction has a high incidence rate and has a significant impact on women’s quality of life.The risk factors of PFD are multifactorial.This systematic review systematically evaluates the influence of different factors on PFD to provide certain evidence for clinical practice.METHODS: In this study,Pub Med,Embase,Google Scholar and Cochrane Library were used to search for relevant literature on the correlation between various factors of childbirth and pelvic floor dysfunction for systematic evaluation.RESULTS: A total of 21 articles(including 1116 patients)were included.Data were extracted for Meta-analysis,and different OR values were obtained.Birth times,perineal lateral resection,and forceps can further contribute to the development of pelvic floor dysfunction.The risk of pelvic organ prolapse after one vaginal delivery was increased(OR 4.83,95%CI 2.27-10.26,P <0.001);After two vaginal deliveries,OR was 1.38(95%CI: 1.11-1.71,P = 0.000).OR for three vaginal deliveries was 1.16(95%CI 1.01-1.33,P <0.001).OR of urinary incontinence after lateral episiotomy was 1.14,95%CI: 1.03,1.27;P = 0.290).The OR of urinary incontinence after forceps delivery was 1.24(95%CI: 1.06--1.45,P=0.5350).The OR of urinary incontinence after epidural analgesia was1.03,95%CI 0.90-1.17,P=0.408.The number of vaginal births is positively correlated with the occurrence of fecal incontinence,and the probability of fecal incontinence is the highest in three vaginal births.Conclusion: Pelvic floor dysfunction is closely related to delivery times,forceps assistant vaginal delivery and episiotomy.