Pelvic Floor Morbidity Following Vaginal Delivery versus Cesarean Delivery: Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Protocol, Eligibility Criteria, Information Sources, and Search Strategies
2.2. Study Selection, Data Collection and Data Items
2.3. Risk of Bias and Statistical Analysis
3. Results
3.1. Characteristic of the Included Studies
3.2. Quality Assessment
3.3. Results of the Systematic Review
3.4. Results of the Meta-Analysis
3.4.1. Meta-Analysis of Morbidity
3.4.2. Meta-Analysis of Urinary Incontinence
3.4.3. Meta-Analysis of Pelvic Organ Prolapse
3.4.4. Meta-Analysis of Anal Incontinence
3.5. Sensitivity Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
VD | Vaginal delivery |
CD | Cesarean delivery |
UI | Urinary incontinence |
POP | Pelvic organ prolapse |
AI | Anal incontinence |
OR | Odds Ratio |
CI | Confidence Interval |
I2 | I squared |
PFD | Pelvic floor disorders |
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Author | Year | Period of Study | Country | Type of Study | Type of Questionnaire | No. of Patients | Mean Age (SD or Range) |
---|---|---|---|---|---|---|---|
Blomquist [18] | 2019 | October 2008–December 2013 | USA | Longitudinal study | Prolapse-Incontinence Questionnaire | 1143 | 40 (36.6 43.7) |
Larsson [17] | 2019 | 1973–2015 | Sweden | Observational study | ICD8-10 diagnosis | 1586.154 | 26.73 (5.57) |
Fairchild [19] | 2019 | August 2014–July 2016 | USA | Prospective cohort | POP-Q, Ultrasound | 112 | 30.62 (N/A) |
Colla [20] | 2018 | August 2016–May 2017 | Brazil | Prospective observational | ICIQ_SF, POP-Q, PFM perineometer data | 227 | 27 (26.03–27.68) |
Abdool [21] | 2017 | November 2015–June 2016 | South Africa | Observational study | ICIQ-VS Questionnaire | 153 | 25.35 (18–38) |
Huser [22] | 2017 | January 2002–December 2007 | Czech | Prospective cohort | Internet-based survey | 865 | N/A |
Yohay [23] | 2016 | March–July 2014 | Israel | Prospective longitudinal cohort | PFDI-20 Questionnaire | 117 | 30.84 (5.05) |
Moossdorff [24] | 2015 | January 2010–December 2010 | Netherlands | Observational study | Web based survey | 169 | 29.74 (N/A) |
Lipschuetz [25] | 2015 | N/A | Israel | Cross sectional study | PFBQ Questionnaire | 198 | 28 (5.7) |
Volloyhaug [26] | 2015 | January 1990–December 1997 | Norway | Cross sectional study | POP-Q questionnaire, ultrasound | 608 | 28.5 (N/A) |
Friedman [27] | 2012 | N/A | USA | Prospective cohort | POP Quantification system | 666 | 32.40 (N/A) |
Dietz [28] | 2012 | October 2005–March 2010 | Australia | Prospective cohort | Questions interview & ultrasound | 513 | 27.5 (17–45) |
Dolan [29] | 2010 | January 1983–August 1986 | UK | Prospective cohort | Sheffield pelvic floor questionnaires | 1857 | 26.2 (4.8) |
Total (N) | 1597.303 |
Heterogeneity Statistic | Degrees of Freedom | p | I-Squared ** | Tau-Squared | |
---|---|---|---|---|---|
UI | 1.09 | 2 | 0.580 | 0.0% | 0.000 |
POP | 8.13 | 3 | 0.043 | 63.1% | 0.1812 |
AI | 3.74 | 3 | 0.291 | 19.8% | 0.0058 |
Overall | 60.46 | 10 | 0.000 | 83.5% | 0.1535 |
z | p | ||||
UI | 9.10 | 0.000 | |||
POP | 4.31 | 0.000 | |||
AI | 5.64 | 0.000 | |||
Overall | 5.40 | 0.000 |
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Barca, J.A.; Bravo, C.; Pintado-Recarte, M.P.; Asúnsolo, Á.; Cueto-Hernández, I.; Ruiz-Labarta, J.; Buján, J.; Ortega, M.A.; De León-Luis, J.A. Pelvic Floor Morbidity Following Vaginal Delivery versus Cesarean Delivery: Systematic Review and Meta-Analysis. J. Clin. Med. 2021, 10, 1652. https://doi.org/10.3390/jcm10081652
Barca JA, Bravo C, Pintado-Recarte MP, Asúnsolo Á, Cueto-Hernández I, Ruiz-Labarta J, Buján J, Ortega MA, De León-Luis JA. Pelvic Floor Morbidity Following Vaginal Delivery versus Cesarean Delivery: Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2021; 10(8):1652. https://doi.org/10.3390/jcm10081652
Chicago/Turabian StyleBarca, Juan A., Coral Bravo, Maria P. Pintado-Recarte, Ángel Asúnsolo, Ignacio Cueto-Hernández, Javier Ruiz-Labarta, Julia Buján, Miguel A. Ortega, and Juan A. De León-Luis. 2021. "Pelvic Floor Morbidity Following Vaginal Delivery versus Cesarean Delivery: Systematic Review and Meta-Analysis" Journal of Clinical Medicine 10, no. 8: 1652. https://doi.org/10.3390/jcm10081652