Vaginal birth tied to later lack of pelvic organ support

(HealthDay)—Vaginal birth is associated with worse pelvic organ support five years after a woman's first delivery, and genital hiatus size is an independent predictor of worse support, according to a study published in the March issue of the American Journal of Obstetrics & Gynecology.

Victoria L. Handa, M.D., from Johns Hopkins University in Baltimore, and colleagues investigated the longitudinal, quantitative changes in pelvic organ support after childbirth, focusing on the impact of vaginal versus cesarean delivery. Women (n = 1,224) were recruited five to 10 years from first delivery and followed annually.

The researchers found that vaginal birth was associated with significantly worse support five years after first delivery. Also, women with at least one vaginal birth had more rapid worsening of support at the vaginal apex. Worse support at five years and the rate of change over time were significantly independently predicted by the width of the genital hiatus.

"Above and beyond the impact of vaginal birth, the size of the genital hiatus may be an independent marker for those at greatest risk of prolapse progression," the authors write.