A study by Yale School of Medicine published earlier this year in the Journal of Reproductive Science  has found an association between increased body mass index (BMI) and the incidence of prolapse in women one year after childbirth.

The research, a collaboration between Yale and Wenzhou Medical College in Zhejiang, looked at data from 108 women recording their BMI from pregnancy to one year after delivery. The women were also given a pelvic floor prolapse assessment one year postpartum.

The researchers found that an increase of just one BMI unit one year after delivery was associated with a 41 per cent increased chance of having a pelvic organ prolapse.

Yale researcher Dr Marsha Guess said that neither their BMI at the start of pregnancy, nor their weight gain during pregnancy had any bearing on their risk of pelvic organ prolapse

“Specifically, the higher the BMI one year after delivery, the higher the risk for having pelvic floor laxity and increased odds for early stage pelvic organ prolapse,” Dr Guess said.

Pelvic organ prolapse is a common condition, with half of all women over 50 who’ve had children affected. A pelvic organ prolapse occurs when the muscles and ligaments supporting a woman’s bladder, bowel and uterus become damaged due to overstretching during pregnancy and/or tearing during the birthing process, causing the organs to slip out of place, or prolapse, into the vagina. The main symptoms of pelvic organ prolapse are urinary and bowel incontinence, difficulty passing bowel motions, sexual problems and an uncomfortable feeling of bulging in the vaginal area.

Guess and her team found that on average, women in their study gained 1.9 kg in the time between the start of pregnancy and one year postpartum.

“Our findings show that even small differences in BMI one year after delivery can lead to pelvic floor laxity in normal-weight women,” Dr Guess said.

This study also suggested that maintaining a healthy weight after delivery was important for good pelvic floor support, which supports the findings of Wing RR et al (2010), that losing between five and 10 per cent of weight decreases the incidence of incontinence by around 70 per cent.

“Getting women into a routine of healthy diet and exercise habits, and back to their baseline weight after delivery may play an important role in preventing the early stages of prolapse,” she added.

Read more about pregnancy and prolapse.


The Effect of Body Mass Index on Pelvic Floor Support 1 Year Postpartum, Yi Chen, MD1 , Benjamin Johnson, MA2 , Fangyong Li, MPH2 , William C. King, PhD2 , Kathleen A. Connell, MD3 , and Marsha K. Guess, MD, MS

Wing RR et al. Improving urinary incontinence in overweight and obese women through modest weight loss. Obstet Gynecol 2010 Aug (2 Pt 1): 284-92