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Pelvic floor symptoms and quality of life 1 year postpartum in Swedish primiparous women—A follow-up of a randomized controlled trial

Edqvist, Malin LU orcid ; Häggsgård, Cecilia LU ; Teleman, Pia LU ; Tegerstedt, Gunilla ; Ajne, Gunilla ; Ullén, Susann ; Tern, Helena LU orcid ; Ängeby, Karin ; Dahlen, Hannah G. and Rubertsson, Christine LU (2026) In Acta Obstetricia et Gynecologica Scandinavica
Abstract

Introduction: Long-term pelvic floor symptoms after childbirth may impair women's quality of life. The aim of this study was to assess the prevalence of self-reported pelvic floor symptoms 1 year postpartum in primiparous women by degree of perineal tear, with a focus on minor and major second-degree tears, and their association with quality of life. Material and Methods: This prospective cohort study was based on data collected within a randomized controlled trial (the Oneplus trial). Women in the trial who had a vaginal birth and responded to a 1-year postpartum follow-up questionnaire were included. Data were collected between January 2020 and May 2021. The main outcome measures were pelvic floor symptoms assessed using the Pelvic... (More)

Introduction: Long-term pelvic floor symptoms after childbirth may impair women's quality of life. The aim of this study was to assess the prevalence of self-reported pelvic floor symptoms 1 year postpartum in primiparous women by degree of perineal tear, with a focus on minor and major second-degree tears, and their association with quality of life. Material and Methods: This prospective cohort study was based on data collected within a randomized controlled trial (the Oneplus trial). Women in the trial who had a vaginal birth and responded to a 1-year postpartum follow-up questionnaire were included. Data were collected between January 2020 and May 2021. The main outcome measures were pelvic floor symptoms assessed using the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7), and study-specific items related to suturing and perceived body image. Associations between type of perineal tear and pelvic floor symptoms and their impact on quality of life were examined using generalized linear models, estimating adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). Trial registration: ClinicalTrials.gov, NCT03770962. Results: The cohort consisted of 1911 primiparous women. Among the tear categories investigated, major second-degree tears were the most common (30.4%), followed by minor second-degree tears (18.4%), episiotomy (9.8%), and obstetric anal sphincter injury (OASI) (5.3%). PFD symptoms were reported by 31.4–51.5% of the women. Women with OASI had an increased risk of colorectal–anal distress compared with those with no tear or a first-degree tear (aRR 1.56, 95% CI 1.24–1.96). No associations were observed between minor or major second-degree tears and pelvic floor symptoms. Increasing tear severity was associated with a higher likelihood of perceiving the vagina as narrow. No differences between tear categories were observed regarding impact on quality of life. Episiotomy was associated with a negative body image related to vaginal symptoms (aRR 1.45, 95% CI 1.03–1.99). Conclusions: Pelvic floor symptoms and their impact on quality of life were common 1 year postpartum, irrespective of perineal tear category. Minor and major second-degree tears were not associated with an increased risk of pelvic floor dysfunction or reduced quality of life.

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organization
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type
Contribution to journal
publication status
epub
subject
keywords
episiotomy, OASI, pelvic floor dysfunction, quality of life, second-degree tears
in
Acta Obstetricia et Gynecologica Scandinavica
publisher
Wiley-Blackwell
external identifiers
  • scopus:105036574582
  • pmid:42027115
ISSN
0001-6349
DOI
10.1111/aogs.70216
language
English
LU publication?
yes
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b00225ad-c505-42e7-820d-efebe430a5ef
date added to LUP
2026-05-25 11:15:31
date last changed
2026-05-26 03:12:44
@article{b00225ad-c505-42e7-820d-efebe430a5ef,
  abstract     = {{<p>Introduction: Long-term pelvic floor symptoms after childbirth may impair women's quality of life. The aim of this study was to assess the prevalence of self-reported pelvic floor symptoms 1 year postpartum in primiparous women by degree of perineal tear, with a focus on minor and major second-degree tears, and their association with quality of life. Material and Methods: This prospective cohort study was based on data collected within a randomized controlled trial (the Oneplus trial). Women in the trial who had a vaginal birth and responded to a 1-year postpartum follow-up questionnaire were included. Data were collected between January 2020 and May 2021. The main outcome measures were pelvic floor symptoms assessed using the Pelvic Floor Distress Inventory (PFDI-20), the Pelvic Floor Impact Questionnaire (PFIQ-7), and study-specific items related to suturing and perceived body image. Associations between type of perineal tear and pelvic floor symptoms and their impact on quality of life were examined using generalized linear models, estimating adjusted risk ratios (aRRs) with 95% confidence intervals (CIs). Trial registration: ClinicalTrials.gov, NCT03770962. Results: The cohort consisted of 1911 primiparous women. Among the tear categories investigated, major second-degree tears were the most common (30.4%), followed by minor second-degree tears (18.4%), episiotomy (9.8%), and obstetric anal sphincter injury (OASI) (5.3%). PFD symptoms were reported by 31.4–51.5% of the women. Women with OASI had an increased risk of colorectal–anal distress compared with those with no tear or a first-degree tear (aRR 1.56, 95% CI 1.24–1.96). No associations were observed between minor or major second-degree tears and pelvic floor symptoms. Increasing tear severity was associated with a higher likelihood of perceiving the vagina as narrow. No differences between tear categories were observed regarding impact on quality of life. Episiotomy was associated with a negative body image related to vaginal symptoms (aRR 1.45, 95% CI 1.03–1.99). Conclusions: Pelvic floor symptoms and their impact on quality of life were common 1 year postpartum, irrespective of perineal tear category. Minor and major second-degree tears were not associated with an increased risk of pelvic floor dysfunction or reduced quality of life.</p>}},
  author       = {{Edqvist, Malin and Häggsgård, Cecilia and Teleman, Pia and Tegerstedt, Gunilla and Ajne, Gunilla and Ullén, Susann and Tern, Helena and Ängeby, Karin and Dahlen, Hannah G. and Rubertsson, Christine}},
  issn         = {{0001-6349}},
  keywords     = {{episiotomy; OASI; pelvic floor dysfunction; quality of life; second-degree tears}},
  language     = {{eng}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Obstetricia et Gynecologica Scandinavica}},
  title        = {{Pelvic floor symptoms and quality of life 1 year postpartum in Swedish primiparous women—A follow-up of a randomized controlled trial}},
  url          = {{http://dx.doi.org/10.1111/aogs.70216}},
  doi          = {{10.1111/aogs.70216}},
  year         = {{2026}},
}