Pelvic floor disorders in postpartum adolescents in the Western Amazon: a cross-sectional study

Figures & data

Table 1 Sociodemographic data according to maternal age, Brazilian Western Amazon, 2016–2017

Variables	Categories	Adolescents (≤19 years) Total n=41	Late adolescents (20–24 years) Total n=103	Young women (25–30 years) Total n=141	P-value*
		n (%)	n (%)	n (%)
Have a partner	Yes	21 (51.2)	56 (54.9)	91 (65)	0.149
	No	20 (48.8)	46 (45.1)	49 (35)
Employed	Yes	21 (51.2)	36 (36.0)	78 (55.3)	0.011
	No	20 (48.8)	64 (64.0)	63 (44.7)
Smoking	Yes	4 (9.8)	7 (6.8)	3 (2.1)	0.075
	No	37 (90.2)	96 (93.2)	138 (97.9)
Contraceptive method	Yes	74 (75.5)	28 (71.8)	102 (75.6)	0.883
	No	24 (24.5)	11 (28.2)	33 (24.4)
Breastfeeding	Yes	27 (65.8)	55 (53.4)	89 (64.0)	0.184
	No	14 (34.2)	48 (46.6)	50 (36.0)
Physical activity	Yes	13 (31.7)	19 (18.4)	24 (17.0)	0.106
	No	28 (68.3)	84 (81.6)	117 (83.0)
Scholarity	Less than 8 years	4 (9.8)	12 (11.8)	10 (7.1)	0.528
	8–12 years	19 (46.3)	57 (55.9)	75 (53.6)
	More than 12 years	18 (43.9)	33 (32.3)	55 (39.3)

Note:

* Chi-squared test.

Table 2 Maternal clinical characteristics and delivery outcomes according to maternal age, Brazilian Western Amazon, 2016–2017

Variables	Categories	Adolescents (≤19 years) Total n=41	Late adolescents (20–24 years) Total n=103	Young women (25–30 years) Total n=141	P-value*
		n (%)	n (%)	n (%)
Parity	One births	29 (70.7)	65 (63.1)	56 (39.7)	<0.001
	Two births	11 (26.8)	29 (28.2)	57 (40.4)
	≥3 births	1 (2.5)	9 (8.7)	28 (19.9)
Prenatal visits	<6 visits	30 (33.7)	13 (35.1)	28 (21.7)	0.085
	≥6 visits	59 (66.3)	24 (64.9)	101 (78.3)
Mode of delivery	Vaginal	21 (51.2)	44 (42.7)	49 (34.7)	0.002
	Cesarean	18 (43.9)	59 (57.3)	92 (65.3)
	Vacuum	2 (4.9)	0	0
Perineal tears	Yes	8 (19.5)	12 (11.6)	13 (9.4)	0.211
	No	33 (80.5)	91 (88.4)	125 (90.6)
Episiotomy	Yes	1 (2.4)	1 (1.0)	2 (1.4)	0.796
	No	40 (97.6)	102 (99.0)	139 (98.6)
Gestational age	Preterm	4 (10.5)	13 (14.1)	15 (11.4)	0.918
	Term	34 (89.5)	78 (84.8)	116 (88.9)
	Post-term	0	1 (1.1)	1 (0.7)
Newborn respiratory dysfunction	Yes	4 (10.5)	6 (6.5)	16 (12.4)	0.343
	No	34 (89.5)	87 (93.5)	113 (87.6)
		Median (95% CI)	Median (95% CI)	Median (95% CI)	P-value**
BMI		22.49 (20.99 to 24.8)	24.46 (22.66 to 25.68)	24.88 (23.94 to 26.03)	0.007
Weight gain		11 (8.0 to 14.3)	11 (9.7 to 13)	12 (10 to 13)	0.925
Weight loss		−10 (−12.3 to 9.0)	−9 (−10.1 to −8.0)	−10 (−11 to −8.26)	0.790
Birth weight		3,420 (3,207 to 3,483.97)	3,275 (3,140 to 3,379)	3,317.5 (3,210 to 3,395.4)	0.324
Birth stature		49 (48 to 49.3)	49 (48 to 49)	49 (48 to 49)	0.647
Newborn HC		34 (34 to 35)	34 (34 to 35)	35 (34 to 35)	0.636
Newborn CC		34 (33 to 35)	34 (33 to 34)	34 (33 to 34)	0.701
Newborn Apgar 1’		8.5 (8 to 9)	8 (8 to 9)	8 (8 to 9)	0.940

Notes:

* Chi-squared test;

** Kruskal–Wallis test.

Abbreviations: BMI, body mass index; newborn HC, newborn head circumference; newborn CC, newborn chest circumference.

Table 3 PFDI-20 questionnaire outcomes comparing adolescents, late adolescents, and young women, Brazilian Western Amazon, 2016–2017

	Symptoms		Crude model*		Adjusted model*
	No	Yes	PR (95% CI)	P-value	PR (95% CI)	P-value
	n (%)	n (%)
POPDI score
Young women	84 (59.6)	57 (40.4)	Reference		Reference
Late adolescents	52 (50.5)	51 (49.5)	1.22 (0.93–1.62)	0.156	1.40 (1.05–1.86)	0.022
Adolescents	12 (29.3)	29 (70.7)	1.75 (1.32–2.32)	<0.001	2.02 (1.49–2.75)	<0.001
CRADI score
Young women	91 (64.5)	50 (35.5)	Reference		Reference
Late adolescents	56 (54.4)	47 (45.6)	1.29 (0.95–1.75)	0.108	1.23 (0.89–1.71)	0.211
Adolescents	20 (48.8)	21 (51.2)	1.44 (0.99–2.10)	0.054	1.42 (0.96–2.10)	0.076
UDI score
Young women	91 (64.5)	50 (35.5)	Reference		Reference
Late adolescents	61 (59.2)	42 (40.8)	1.15 (0.83–1.59)	0.396	1.25 (0.90–1.76)	0.186
Adolescents	15 (36.6)	26 (63.4)	1.79 (1.30–2.47)	<0.001	2.09 (1.47–2.98)	<0.001
PFDI total score
Young women	84 (59.6)	57 (40.4)	Reference		Reference
Late adolescents	50 (48.5)	53 (51.5)	1.27 (0.97–1.68)	0.085	1.35 (1.01–1.81)	0.040
Adolescents	10 (24.4)	31 (75.6)	1.87 (1.43–2.44)	<0.001	2.12 (1.57–2.87)	<0.001
UI
Young women	100 (70.9)	41 (29.1)	Reference		Reference
Late adolescents	66 (64.1)	37 (35.9)	1.24 (0.86–1.78)	0.257	1.27 (0.86–1.88)	0.228
Adolescents	21 (51.2)	20 (48.8)	1.68 (1.12–2.52)	0.013	1.75 (1.14–2.69)	0.010
UUI
Young women	114 (80.9)	27 (19.1)	Reference		Reference
Late adolescents	83 (80.6)	20 (19.4)	1.01 (0.60–1.71)	0.958	1.04 (0.59–1.81)	0.898
Adolescents	28 (68.3)	13 (31.7)	1.66 (0.94–2.91)	0.080	1.88 (1.02–3.47)	0.043
SUI
Young women	114 (80.9)	27 (19.1)	Reference		Reference
Late adolescents	84 (81.6)	19 (18.4)	0.96 (0.57–1.64)	0.890	1.09 (0.63–1.91)	0.750
Adolescents	28 (68.3)	13 (31.7)	1.66 (0.94–2.91)	0.080	2.00 (1.11–3.62)	0.021
FI
Young women	135 (95.7)	6 (4.26)	Reference		Reference
Late adolescents	97 (94.2)	6 (5.8)	1.37 (0.45–4.13)	0.577	1.46 (0.40–5.27)	0.567
Adolescents	33 (80.5)	8 (19.5)	4.59 (1.68–12.48)	0.003	4.40 (1.36–14.27)	0.014
POP
Young women	135 (95.7)	6 (4.3)	Reference		Reference
Late adolescents	97 (94.2)	6 (5.8)	1.37 (0.45–4.13)	0.577	1.52 (0.50–4.63)	0.457
Adolescents	39 (95.1)	2 (4.9)	1.14 (0.24–5.48)	0.864	1.95 (0.34–11.04)	0.450

Note:

* Poisson Regression model with robust variance.

Abbreviations: PFDI-20, Pelvic Floor Distress Inventory-20; PR, prevalence ratio; POPDI, Pelvic Organ Prolapse Distress Inventory; CRADI, Colorectal Anal Distress Inventory; UDI, Urinary Distress Inventory; PFDI, Pelvic Floor Distress Inventory; UI, urinary incontinence; UUI, urge urinary incontinence; SUI, stress urinary incontinence; FI, fecal incontinence; POP, pelvic organ prolapse.

Table 4 PFDI-20 questionnaire outcomes comparing adolescents, late adolescents, and young women, according to mode of delivery, Brazilian Western Amazon, 2016–2017

	Vaginal delivery				Cesarean delivery
	No N (%)	Yes N (%)	PR (95% CI)*	P-value*	No N (%)	Yes N (%)	PR (95% CI)*	P-value*
POPDI score
Young women	30 (61.2)	19 (38.8)	Reference		54 (58.7)	38 (41.3)	Reference
Late adolescents	27 (61.4)	17 (38.6)	1.00 (0.60–1.67)	0.989	25 (42.4)	34 (57.6)	1.40 (1.00–1.94)	0.047
Adolescents	9 (42.9)	12 (57.1)	1.47 (0.88–2.46)	0.139	2 (11.1)	16 (88.9)	2.15 (1.60–2.89)	<0.001
CRADI score
Young women	32 (65.3)	17 (34.7)	Reference		59 (64.1)	33 (35.9)	Reference
Late adolescents	26 (59.1)	18 (40.9)	1.18 (0.70–1.99)	0.539	30 (50.9)	29 (49.1)	1.37 (0.94–2.00)	0.102
Adolescents	12 (57.1)	9 (42.9)	1.24 (0.66–2.32)	0.510	8 (44.4)	10 (55.6)	1.55 (0.94–2.55)	0.084
UDI score
Young women	33 (67.4)	16 (32.6)	Reference		58 (63.0)	34 (37.0)	Reference
Late adolescents	30 (68.2)	14 (31.8)	0.97 (0.54–1.76)	0.932	31 (52.5)	28 (47.5)	1.28 (0.88–1.88)	0.197
Adolescents	10 (47.6)	11 (52.4)	1.60 (0.90–2.85)	0.107	3 (16.7)	15 (83.3)	2.25 (1.61–3.16)	<0.001
PFDI total score
Young women	28 (57.1)	21 (42.9)	Reference		56 (60.9)	36 (39.1)	Reference
Late adolescents	23 (52.3)	21 (47.7)	1.11 (0.71–1.75)	0.639	27 (45.8)	32 (54.2)	1.39 (0.98–1.96)	0.065
Adolescents	8 (38.1)	13 (61.9)	1.44 (0.90–2.30)	0.124	2 (11.1)	16 (88.9)	2.27 (1.68–3.08)	<0.001
UI
Young women	33 (67.4)	16 (32.6)	Reference		67 (72.8)	25 (27.2)	Reference
Late adolescents	27 (61.4)	17 (38.6)	1.18 (0.68–2.05)	0.549	39 (66.1)	20 (33.9)	1.25 (0.76–2.04)	0.377
Adolescents	10 (47.6)	11 (52.4)	1.60 (0.90–2.85)	0.107	9 (50.0)	9 (50.0)	1.84 (1.04–3.26)	0.037
UUI
Young women	35 (71.4)	14 (28.6)	Reference		79 (85.9)	13 (14.1)	Reference
Late adolescents	36 (81.8)	8 (18.2)	0.64 (0.29–1.38)	0.250	47 (79.7)	12 (20.3)	1.44 (0.70–2.94)	0.318
Adolescents	14 (66.7)	7 (33.3)	1.17 (0.55–2.48)	0.688	12 (66.7)	6 (33.3)	2.36 (1.03–5.40)	0.042
SUI
Young women	40 (81.6)	9 (18.4)	Reference		74 (80.4)	18 (19.6)	Reference
Late adolescents	37 (84.1)	7 (15.9)	0.87 (0.35–2.14)	0.755	47 (79.7)	12 (20.3)	1.04 (0.54–2.00)	0.908
Adolescents	15 (71.4)	6 (28.6)	1.56 (0.63–3.83)	0.337	11 (61.1)	7 (38.9)	1.99 (0.97–4.06)	0.059
FI
Young women	48 (98.0)	1 (2.0)	Reference		87 (94.6)	5 (5.4)	Reference
Late adolescents	44 (100)	0	NA	NA	53 (89.8)	6 (10.2)	1.87 (0.60–5.88)	0.283
Adolescents	17 (80.9)	4 (19.1)	9.33 (1.10–79.32)	0.041	14 (77.8)	4 (22.2)	4.09 (1.21–13.81)	0.023
POP
Young women	46 (93.9)	3 (6.1)	Reference		89 (96.7)	3 (3.3)	Reference
Late adolescents	41 (93.2)	3 (6.8)	1.11 (0.24–5.27)	0.892	56 (94.9)	3 (5.1)	1.56 (0.32–7.50)	0.579
Adolescents	20 (95.2)	1 (4.8)	0.78 (0.08–7.12)	0.824	17 (94.4)	1 (5.6)	1.70 (0.19–15.57)	0.637

Note:

* Poisson Regression model with robust variance.

Abbreviations: PFDI-20, Pelvic Floor Distress Inventory-20; PR, prevalence ratio; POPDI, Pelvic Organ Prolapse Distress Inventory; CRADI, Colorectal Anal Distress Inventory; NA, not applicable, as no case was detected for this category; UDI, Urinary Distress Inventory; PFDI, Pelvic Floor Distress Inventory; UI, urinary incontinence; UUI, urge urinary incontinence; SUI, stress urinary incontinence; FI, fecal incontinence; POP, pelvic organ prolapse.