Prevalence, Knowledge and Awareness of Pelvic Floor Disorder among Pregnant Women in a Tertiary Centre, Malaysia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Instruments and Data Collection
2.3. Data Analysis
3. Results
3.1. Prevalence of Pelvic Floor Disorders among Pregnant Women
3.2. Knowledge and Awareness of Pelvic Floor Disorders among Pregnant Women
4. Discussion
4.1. Prevalence of Pelvic Floor Disorders among Pregnant Women
4.2. Knowledge and Awareness of Pelvic Floor Disorders among Pregnant Women
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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N = 424 | |
---|---|
Age, years | 31.5 (29.0, 35.0) |
Ethnicity, n (%) | |
• Malay | 331 (78.1) |
• Chinese | 67 (15.8) |
• Indian | 9 (2.1) |
• Other | 17 (4.0) |
Married, n (%) | 417 (98.3) |
Primiparity | 141 (33.3) |
Gestational age, weeks | 36.1 (32.0, 38.2) |
Body Mass Index (kg/m2) | 27.0 (24.0, 314) |
Maternal educational level, n (%) | |
• Primary | 1 (0.2) |
• Secondary | 111 (26.2) |
• College | 79 (18.6) |
• Tertiary | 233 (55.0) |
Antenatal class, n (%) | 85 (20.0) |
Level of antenatal care, n (%) | |
• Local clinic | 245 (57.8) |
• O&G MO/trainee | 46 (10.8) |
• Specialist care | 133 (31.4) |
Previous gynaecological surgery | 14 (8.3) |
PFDI Item | Prevalence within the Group | Frequency | |
---|---|---|---|
1 | POPDI | 41.8% | 232 (54.7) |
2 | 205 (48.3) | ||
3 | 147 (34.7) | ||
4 | 147 (34.7) | ||
5 | 202 (37.6) | ||
6 | 112 (26.4) | ||
7 | CRADI | 37.8% | 167 (39.4) |
8 | 179 (42.2) | ||
9 | 127 (30.0) | ||
10 | 135 (31.8) | ||
11 | 148 (34.9) | ||
12 | 141 (33.3) | ||
13 | 208 (49.1) | ||
14 | 138 (32.5) | ||
15 | UDI | 62.7% | 266 (62.7) |
16 | 199 (46.9) | ||
17 | 231 (54.4) | ||
18 | 188 (44.3) | ||
19 | 146 (34.4) | ||
20 | 177 (41.7) | ||
21 | 152 (35.8) | ||
22 | 186 (43.9) |
Bil | Questions | NO | Yes. If Yes, How Much Does This Bother You? | |||
---|---|---|---|---|---|---|
Not at All | Somewhat | Moderately | Quite a Bit | |||
POPDI-6 | ||||||
1. | Do you usually experience PRESSURE in the lower abdomen? | 192 (45.3) | 57 (13.4) | 56 (13.2) | 55 (13.0) | 64 (15.1) |
2. | Do you usually experience HEAVINESS or DULLNESS in the pelvic are? | 219 (51.7) | 63 (14.9) | 35 (8.3) | 55 (13.0) | 52 (12.3) |
3. | Do you usually have a bulge or something falling out that you can see or feel in the vaginal area? | 277 (65.3) | 87 (20.5) | 18 (4.2) | 26 (6.1) | 16 (3.8) |
4. | Do you usually have to push on the vagina or around the rectum to have or complete a bowel movement? | 277 (65.3) | 78 (18.4) | 26 (6.1) | 21 (5.0) | 22 (5.2) |
5. | Do you usually experience a feeling of incomplete bladder emptying? | 222 (52.4) | 59 (13.9) | 50 (11.8) | 45 (10.6) | 48 (11.3) |
6. | Do you ever have to push up on a bulge in the vaginal area with your fingers to start or complete urination? | 312 (73.6) | 78 (18.4) | 15 (3.5) | 13 (3.1) | 6 (1.4) |
CRADI-8 | ||||||
7. | Do you feel you need to strain too hard to have a bowel movement? | 257 (60.6) | 72 (17.0) | 34 (8.0) | 44 (10.4) | 17 (4.0) |
8. | Do you feel you have not completely emptied your bowels at the end of a bowel movement? | 245 (57.8) | 68 (16.0) | 44 (10.4) | 38 (9.0) | 29 (6.8) |
9. | Do you usually lose stool beyond your control if your stool is well formed? | 297 (70.0) | 79 (18.6) | 20 (4.7) | 17 (4.0) | 11 (2.6) |
10. | Do you usually lose stool beyond your control if your stool is loose or liquid? | 289 (68.2) | 74 (17.5) | 17 (4.0) | 23 (5.4) | 21 (5.0) |
11. | Do you usually lose gas from the rectum beyond your control? | 276 (65.1) | 67 (15.8) | 21 (5.0) | 33 (7.8) | 27 (6.4) |
12. | Do you usually have pain when you pass your stool? | 283 (66.7) | 67 (15.8) | 23 (5.4) | 28 (6.6) | 23 (5.4) |
13. | Do you experience a strong sense of urgency and have to rush to the bathroom to have a bowel movement? | 216 (50.9) | 72 (17.0) | 47 (11.1) | 47 (11.1) | 42 (9.9) |
14. | Does a part of your bowel ever pass through the rectum and bulge outside during or after a bowel movement? | 286 (67.5) | 82 (19.3) | 23 (5.4) | 17 (4.0) | 16 (3.8) |
UDI-6 | ||||||
15. | Do you usually experience frequent urination? | 158 (37.3) | 54 (12.7) | 63 (14.9) | 80 (18.9) | 69 (16.3) |
16. | Do you usually experience urinary leakage associated with a feeling of urgency, that is, a strong sensation of needing to go to the bathroom? | 225 (53.1) | 64 (15.1) | 47 (11.1) | 42 (9.9) | 46 (10.8) |
17. | Do you usually experience urinary leakage related to coughing, sneezing, or laughing? | 193 (45.5) | 57 (13.4) | 62 (14.6) | 54 (12.7) | 58 (13.7) |
18. | Do you usually experience small amounts of urinary leakage, that is, drops? | 236 (55.7) | 52 (12.3) | 54 (12.7) | 46 (10.8) | 36 (8.5) |
19. | Do you usually experience difficulty emptying your bladder? | 278 (65.6) | 72 (17.0) | 28 (6.6) | 25 (5.9) | 21 (5.0) |
20. | Do you usually experience PAIN or DISCOMFORT in the lower abdomen or genital region? | 247 (58.3) | 71 (16.7) | 38 (9.0) | 39 (9.2) | 29 (6.8) |
21. | Do you have pain with sexual intercourse? | 272 (64.2) | 64 (15.1) | 36 (8.5) | 32 (7.5) | 20 (4.7) |
22. | Have you noticed that your interest in sex has decreased? | 238 (56.1) | 71 (16.7) | 37 (8.7) | 48 (11.3) | 30 (7.1) |
Bil | Questions | Correctly Answered | Wrongly Answered | Unsure |
---|---|---|---|---|
1. | Urinary incontinence (loss of urine or leaky bladder) is more common in younger women than in older women. (PATHOGENESIS) | 218 (51.4) | 78 (18.4) | 128 (30.2) |
2. | Women are more likely than men to leak urine. (PATHOGENESIS) | 271 (63.9) | 39 (9.2) | 114 (26.9) |
3. | Other than pads and diapers, not much can be done to treat the leakage of urine. (TREATMENT) | 136 (32.1) | 146 (34.4) | 142 (33.5) |
4. | It is NOT important to diagnose the type of urinary leakage before trying to treat it. (DIAGNOSIS) | 271 (63.9) | 54 (12.7) | 99 (23.3) |
5. | Many things can cause urinary leakage. (PATHOGENESIS) | 314 (74.1) | 22 (5.2) | 88 (20.8) |
6. | Certain exercises can be performed to help control urinary leakage. (TREATMENT) | 314 (74.1) | 18 (4.2) | 92 (21.7) |
7. | Some medications may cause urinary leakage. (PATHOGENESIS) | 158 (37.3) | 31 (7.3) | 235 (55.4) |
8. | Once people start to leak urine, they are never able to control their urine again. (TREATMENT) | 228 (53.8) | 57 (13.4) | 139 (32.8) |
9. | Doctors can perform special types of bladder testing to diagnose urinary leakage. (DIAGNOSIS) | 249 (58.7) | 12 (2.8) | 163 (38.4) |
10. | Surgery is the only treatment for urinary leakage. (TREATMENT) | 161 (38.0) | 45 (10.6) | 218 (51.4) |
11. | Giving birth many times may lead to urinary leakage. (PATHOGENESIS) | 169 (39.9) | 73 (17.2) | 182 (42.9) |
12. | Most people who leak urine can be cured or can improve with some kind of treatment. (TREATMENT) | 303 (71.5) | 7 (1.7) | 114 (26.9) |
Median number of people in each group | 232 | 48 | 142 | |
Median Score PIKQ—Urinary Incontinence | 7.0 (5.0, 9.0) |
Bil | Questions | Correctly Answered | Wrongly Answered | Unsure |
---|---|---|---|---|
1. | Pelvic organ prolapse (bulging of the vagina, uterus, bladder, or rectum) is more common in younger women than in older women. (PATHOGENESIS) | 181 (42.7) | 68 (16.0) | 175 (41.3) |
2. | Giving birth many times may lead to pelvic organ prolapse. (PATHOGENESIS) | 208 (49.1) | 50 (11.8) | 166 (39.2) |
3. | Pelvic organ prolapse can happen at any age. (PATHOGENESIS) | 287 (67.7) | 21 (5.0) | 116 (27.4) |
4. | Certain exercises can help to stop pelvic organ prolapse from getting worse. (TREATMENT) | 293 (69.1) | 12 (2.8) | 119 (28.1) |
5. | Symptoms of pelvic organ prolapse may include pelvic heaviness and/or pressure. (DIAGNOSIS) | 256 (60.4) | 10 (2.4) | 158 (37.3) |
6. | A good way for a doctor to diagnose pelvic organ prolapse is by examining the patient. (DIAGNOSIS) | 330 (77.8) | 10 (2.4) | 84 (19.8) |
7. | Once a patient has pelvic organ prolapse, not much can be done to help her. (TREATMENT) | 221 (52.1) | 38 (9.0) | 165 (38.9) |
8. | Heavy lifting on a daily basis can lead to pelvic organ prolapse. (PATHOGENESIS) | 260 (61.3) | 16 (3.8) | 148 (34.9) |
9. | Surgery is one type of treatment for pelvic organ prolapse. (TREATMENT) | 166 (39.2) | 44 (10.4) | 214 (50.5) |
10. | Doctors can run a blood test to diagnose pelvic organ prolapse. (DIAGNOSIS) | 79 (18.6) | 98 (23.1) | 247 (58.3) |
11. | A rubber ring called a pessary can be used to treat symptoms of pelvic organ prolapse. (TREATMENT) | 113 (26.7) | 15 (3.5) | 296 (69.8) |
12. | People who are obese are less likely to get pelvic organ prolapse. (PATHOGENESIS) | 96 (22.6) | 71 (16.7) | 257 (60.6) |
Median number of people in each group | 207 | 37 | 178 | |
Median Score PIKQ—Pelvic Organ Prolapse | 6.0 (4.0, 8.0) | |||
Total overall score PIKQ | 12.0 (8.0, 17.0) |
PIKQ—UI | PIKQ—POP | ||
---|---|---|---|
Level of knowledge, n (%) | Proficiency | 83 (19.6) | 233 (55.0) |
Low | 341 (80.4) | 191 (45.0) |
Characteristics | PIKQ—UI | PIKQ—POP | ||||
---|---|---|---|---|---|---|
Proficiency (n = 83) | Low (n = 341) | Odd Ratios (CI) p Value | Proficiency (n = 233) | Low (n = 191) | Odd Ratios (CI) p Value | |
Age < 35 years old | 61 (73.5) | 270 (79.2) | 0.729 (0.419–1.268) 0.300 | 175 (75.1) | 156 (81.7) | 0.667 (0.422–1.085) 0.125 |
Married | 80 (96.4) | 337 (98.8) | 0.317 (0.069–1.442) 0.139 | 228 (97.9) | 189 (98.9) | 0.483 (0.093–2.515) 0.465 |
Primiparity | 27 (32.5) | 114 (33.4) | 0.960 (0.576–1.601) 1.000 | 80 (34.3) | 61 (31.9) | 1.114 (0.742–1.674) 0.606 |
Obesity | 34 (41.0) | 92 (27.0) | 1.863 (1.129–3.074) 0.016 | 78 (33.5) | 48 (25.1) | 1.455 (0.949–2.230) 0.087 |
Tertiary level education | 67 (80.7) | 166 (48.7) | 4.415 (2.459–7.926) 0.000 | 152 (65.2) | 81 (42.4) | 2.548 (1.719–3.778) 0.000 |
Antenatal specialist care | 47 (56.6) | 86 (25.2) | 3.871 (2.352–6.371) 0.000 | 97 (41.6) | 36 (18.8) | 3.071 (1.965–4.799) 0.000 |
Antenatal class | 19 (22.9) | 66 (19.3) | 1.237 (0.694–2.205) 0.449 | 52 (22.3) | 33 (17.3) | (1.376 (0.846–2.235) 0.233 |
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Nur Farihan, M.; Ng, B.K.; Phon, S.E.; Nor Azlin, M.I.; Nur Azurah, A.G.; Lim, P.S. Prevalence, Knowledge and Awareness of Pelvic Floor Disorder among Pregnant Women in a Tertiary Centre, Malaysia. Int. J. Environ. Res. Public Health 2022, 19, 8314. https://doi.org/10.3390/ijerph19148314
Nur Farihan M, Ng BK, Phon SE, Nor Azlin MI, Nur Azurah AG, Lim PS. Prevalence, Knowledge and Awareness of Pelvic Floor Disorder among Pregnant Women in a Tertiary Centre, Malaysia. International Journal of Environmental Research and Public Health. 2022; 19(14):8314. https://doi.org/10.3390/ijerph19148314
Chicago/Turabian StyleNur Farihan, Mukhtar, Beng Kwang Ng, Su Ee Phon, Mohamed Ismail Nor Azlin, Abdul Ghani Nur Azurah, and Pei Shan Lim. 2022. "Prevalence, Knowledge and Awareness of Pelvic Floor Disorder among Pregnant Women in a Tertiary Centre, Malaysia" International Journal of Environmental Research and Public Health 19, no. 14: 8314. https://doi.org/10.3390/ijerph19148314