Effect of gestational weight gain on postpartum pelvic floor function in twin primiparas: a single-center retrospective study in China

Abstract

Background The effect of GWG as a controllable factor during pregnancy on pelvic floor function has rarely been investigated, and studies on twin primiparas are even less frequent. The objective of the present study was to explore the correlation between GWG and postpartum pelvic floor function in twin primiparas. Methods We retrospectively analyzed the clinical data of 184 twin primiparas in the pelvic floor rehabilitation system of the First Affiliated Hospital of Chongqing Medical University from January 2020 to October 2021. Based on the GWG criteria recommended by the Institute of Medicine, the study subjects were divided into two groups: adequate GWG and excessive GWG. Univariate and multivariate logistic regression models were applied to explore the relationship between GWG and pelvic floor. Results Among the 184 twin primiparas, 20 (10.87%) had excessive GWG. The rates of abnormal vaginal dynamic pressure (95% vs 74.39%), severely impaired type I muscle fibers (80% vs 45.73%), anterior vaginal wall prolapse (90% vs 68.90%), and stress urinary incontinence (50% vs 20.12%) of twin primiparas with excessive GWG were significantly higher than those with adequate GWG. There was no significant difference between the total score of the PFDI-20 or the scores of the POPDI-6, CRADI-8, and UDI-6 in the two groups (P > 0.05). After adjusting for potential confounding factors, the results showed that excessive GWG was positively associated with abnormal vaginal dynamic pressure (OR = 8.038, 95% CI: 1.001–64.514), severely impaired type I muscle fibers (OR = 8.654, 95% CI: 2.462–30.416), anterior vaginal wall prolapse (OR = 4.705, 95% CI: 1.004–22.054), and stress urinary incontinence (OR = 4.424, 95% CI: 1.578–12.403). Conclusion Excessive GWG in twin primiparas was positively correlated with the prevalence of pelvic floor dysfunction, which did not exacerbate pelvic floor symptoms in twin primiparas. Reasonable control of GWG is beneficial in reducing the risk of abnormal pelvic floor function. Therefore, individualized management for twin pregnancies, providing healthy lifestyle guidance, and promoting weight management should be an important part of perinatal care.