Skip to main content
PFD Week 2024 Main banner
Back

Rapid Fire Oral Presentations 03: Disparities, Office Practice & Special Populations

Grand and Great-Grand Multiparity! – Do They Pose a Urogynecologic Problem?

Friday, October 25, 2024
4:21 PM – 4:24 PM EDT
Location: Independence Ballroom A-D (Meeting Level 4)
Kaplan -Meier Curve correlating risk of pelvic floor disorder with each delivery
Prevalence of PFD by Age Group
table 1.docxtable 2.docx
Objectives: Pelvic floor disorder (PFD) poses a significant health concern for women, influencing their well-being and reproductive decisions. Existing studies have predominantly focused on the impact of parity within the 1-4 range and mode of delivery, leaving a critical knowledge gap regarding grand multiparity (GM: 5-9) and great-grand multiparity (GGM: >10). This study aims to address this gap by examining the prevalence of PFD symptoms in these specific populations and comparing them to women with 1-4 deliveries.

Methods: A cross-sectional study was conducted between January 2021 and January 2023. A questionnaire about pelvic organ prolapse, urinary, and bowel symptoms was administered to participants with a parity of one or more, aged 18 or older. Demographic and obstetric data were obtained through chart reviews. Statistical analyses, including descriptive, univariate, and multivariable analyses, were performed using Stata/IC 16.1.

Results: Among the 405 participants, 35% reported urinary incontinence, 1.7% fecal incontinence, and 9.65% reported a vaginal bulge. Overall, GM and GGM populations exhibited a higher prevalence of PFD symptoms compared to those with 1-4 deliveries (p=0.01) (Table 1). Stratification by age revealed a greater likelihood of PFD in patients delivering at or over 35 years, regardless of parity. This was particularly pronounced in those with four or fewer deliveries (Table 2). The Kaplan Meier curve indicated increasing PFD with increasing parity, up to six deliveries, beyond which the risk of PFD with each additional delivery was negligible, suggesting a cutoff in parity beyond which PFD does not further increase with additional deliveries (Figure 1).

Conclusions: This study contributes valuable insights into the relationship between reproductive history and PFD. While GM and GGM patients overall experienced more PFD symptoms, the risk plateaued beyond six deliveries, offering reassurance to women contemplating additional pregnancies beyond this. The results highlight the risk of PFD even with low parity for women aged 35 and older, and clinicians can utilize this data to counsel on potential risks associated with advanced maternal age in relation to the development of PFD.
Disclosure(s):
Sujatha Narayanamoorthy, MD: No financial relationships to disclose
Olivia Sher Sher, MSPH: No financial relationships to disclose
Bracha Gluck, BS: No financial relationships to disclose
Kimen Balhotra, MD: No financial relationships to disclose
Rachel Furuya, MD: No financial relationships to disclose
Arshia Sandozi, DO, MPH: No financial relationships to disclose
Karis Buford, MD: No financial relationships to disclose
Miriam A. Andrusier, MD, MPH: No financial relationships to disclose
Claire Yin, BA: No financial relationships to disclose
Liliya Vafina, MPA: No financial relationships to disclose
Michael Silver, MS: No financial relationships to disclose
Rodney McLaren, MD, Jr.: No financial relationships to disclose
Elishia McKay, MD: No financial relationships to disclose
Allison Polland, MD: No financial relationships to disclose

    Rapid Fire Presenter(s)

  • Sujatha Narayanamoorthy, MD (she/her/hers)

    Fellow, Division of Urogynecology and Reconstructive Pelvic Surgery
    Mayo Clinic
    Rochester, Minnesota, United States

    Disclosure(s): No financial relationships to disclose

    • Co-Author(s)

  • OS

    Olivia Sher Sher, MSPH

    Research Manager
    Maimonides Medical Center
    967 48th st, New York, United States

    Disclosure(s): No financial relationships to disclose

  • BG

    Bracha Gluck, BS (she/her/hers)

    Research assistant
    Maimonides Medical Center
    Brooklyn, New York, United States

    Disclosure(s): No financial relationships to disclose

  • KB

    Kimen Balhotra, MD

    Maternal Fetal Medicine Fellow
    Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
    Houston, Texas, United States

    Disclosure(s): No financial relationships to disclose

  • RF

    Rachel Furuya, MD

    Resident physician
    Washington University in St. Louis
    St. Louis, Missouri, United States

    Disclosure(s): No financial relationships to disclose

  • Arshia Sandozi, DO, MPH

    Urology Resident
    Maimonides Medical Center
    Brooklyn, New York, United States

    Disclosure(s): No financial relationships to disclose

  • KB

    Karis Buford, MD

    Fellow
    Corewell Health William Beaumont University Hospital
    Royal Oak, Michigan, United States

    Disclosure(s): No financial relationships to disclose

  • MA

    Miriam A. Andrusier, MD, MPH

    Resident Physician
    Brigham and Women's Hospital
    Boston, Massachusetts, United States

    Disclosure(s): No financial relationships to disclose

  • CY

    Claire Yin, BA

    Student Researcher
    Maimonides Medical Center
    Brooklyn, New York, United States

    Disclosure(s): No financial relationships to disclose

  • LV

    Liliya Vafina, MPA

    Quality and Regulatory Specialist
    Mount Sinai
    Brooklyn, New York, United States

    Disclosure(s): No financial relationships to disclose

  • MS

    Michael Silver, MS

    Biostatistician
    Maimonides Health
    Brooklyn, New York, United States

    Disclosure(s): No financial relationships to disclose

  • RM

    Rodney McLaren, Jr., MD

    Assistant Professor of OB/Gyn, Maternal-Fetal Medicine Faculty
    Sidney Kimmel Medical College at the Thomas Jefferson University
    Philadelphia, Pennsylvania, United States

    Disclosure(s): No financial relationships to disclose

  • EM

    Elishia McKay, MD

    MD, URPS
    Maimonides Medical Center
    brooklyn, New York, United States

    Disclosure(s): No financial relationships to disclose

  • AP

    Allison Polland, MD (she/her/hers)

    Vice Chair, Department of Surgery
    Maimonides Medical Center
    Brooklyn, New York, United States

    Disclosure(s): No financial relationships to disclose