Abstract
Introduction The aim of this study was to develop and validate a questionnaire for the assessment
of pelvic floor disorders, their symptoms and risk factors in pregnancy and after
birth including symptom course, severity and impact on quality of life.
Methods The validated German pelvic floor questionnaire was modified and a new risk factor
domain developed. The questionnaire was initially completed by 233 nulliparous women
in the third trimester of pregnancy and at six weeks (n = 148) and one year (n = 120)
post partum. Full pyschometric testing was performed. The clinical course of symptoms
and the influence of risk factors were analysed.
Results Study participants had a median age of 31 (19–46) years. 63 % had spontaneous vaginal
deliveries, 15 % operative vaginal deliveries and 22 % were delivered by caesarean
section. Content validity: Missing answers never exceeded 4 %. Construct validity:
The questionnaire distinguished significantly between women who reported bothersome
symptoms and those who did not. Reliability: Cronbachʼs alpha values exceeded 0.7
for bladder, bowel and support function, and 0.65 for sexual function. The test-retest
analysis showed moderate to almost complete concordance. The intraclass coefficients
for domain scores (between 0.732 and 0.818) were in acceptable to optimal range. Reactivity:
The questionnaire was able to track changes significantly with good effect size for
each domain. Risk factors for pelvic floor symptoms included familial predisposition,
maternal age over 35 years, BMI above 25, nicotine abuse, subjective inability to
voluntarily contract the pelvic floor musculature and postpartum wound pain.
Conclusion This pelvic floor questionnaire proved to be valid, reliable and reactive for the
assessment of pelvic floor disorders, their risk factors, incidence and impact on
quality of life during pregnancy and post partum. The questionnaire can be utilised
to assess the course of symptoms and treatment effects using a scoring system.
Key words
pelvic floor dysfunction/disorders - pregnancy - post partum - questionnaire
