Top

International Urogynecology Journal

Published in:

01-08-2015 | Original Article

Association of antepartum vitamin D levels with postpartum pelvic floor muscle strength and symptoms

Authors: S. Aydogmus, S. Kelekci, H. Aydogmus, M. Demir, B. Yilmaz, R. Sutcu

Published in: International Urogynecology Journal | Issue 8/2015

Abstract

Introduction and hypothesis

Vitamin D affects skeletal muscle strength and functions via various mechanisms. Strength and/or functional dysfunctions of the pelvic floor muscles may be associated with the distortion of pelvic floor functions. We hypothesized that vitamin D deficiency may contribute to pelvic floor dysfunction (PFD) by affecting pelvic floor muscle strength (PFMS). The aim of this study was to assess the effect of vitamin D deficiency during pregnancy on postpartum PFMS.

Methods

This cross-sectional study was conducted in a university hospital. One hundred and eighty pregnant women were admitted to our hospital in their third trimester and compared with 156 healthy nulliparous women. Venous blood samples for examining vitamin D levels were taken from each participant and stored at −80 °C. At 8–10 weeks postpartum, patients were invited to the hospital, asked about their PFD symptoms, and PFMS was measured using a perineometer.

Results

There was no statistical significance among groups regarding mean age, maternal age, and weight at delivery. Postpartum PFMS and duration in vitamin D-deficient women were significantly lower than those without the deficiency. Vitamin D-deficient vaginal delivery cases (group I) had a postpartum PFMS average of 21.96 ± 7.91 cm-H₂O, nonvitamin D-deficient normal delivery cases (group III) had a PFMS of 29.66 ± 10.3 cm-H₂O (p = 0.001). In the cesarean delivery groups, vitamin D-deficient (group II) and nonvitamin D-deficient (group IV) cases had PFMS values of 32.23 ± 9.66 and 35.53 ± 15.58 cm-H₂O respectively (p = 0.258).

Conclusions

Lower vitamin D levels in the third trimester correlates with decreased PFMS.

Ward KA, Das G, Roberts SA, Berry JL, Adams JE, Rawer R, Mugal MZ (2010) A randomised, controlled trial of vitamin D supplementation upon musculoskeletal health in postmenarchal females. J Clin Endocrinol Metab 95(10):4643–4651. doi: 10.1210/jc.2009-2725 PubMedCrossRef

Badalian SS, Rosenbaum PF (2010) Vitamin D and pelvic floor disorders in women: results from the national health and nutrition examination survey. Obstet Gynecol 115:795–803. doi:10.1097/AOG.0b013e3181d34806 PubMedCrossRef

Ginde AA, Sullivan AF, Mansbach JM, Camargo CA Jr (2010) Vitamin D insufficiency in pregnant and non-pregnant women of childbearing age in the United States. Am J Obstet Gynecol 202:436.e1–436.e8. doi:10.1016/j.ajog.2010.02.040 CrossRef

Ergur AT, Berberoglu M, Atasay B et al (2009) Vitamin D deficiency in Turkish mothers and their neonates and in women of reproductive age. J Clin Res Pediatr Endocrinol 1:266–269. doi:10.4274/jcrpe.v1i6.266 PubMedCentralPubMedCrossRef

Yeşiltepe-Mutlu G, Hatun Ş (2011) Perinatal D vitamini yetersizliği. Çocuk Sağlığı ve Hastalıkları Dergisi 54:87–98. doi:10.1111/j.1651-2227.2011.02383

Cam C, Karateke A, Sakallı M (2007) Validation of the short forms of incontinence impact questionnaire (IIQ-7) and urogenital distress inventory (UDI-6) in a Turkish population. Neurourol Urodyn 26:129–133PubMedCrossRef

Dallosso HM, McGrother CW, Matthes RU, Donaldson MMK (2004) Nutrient composition of the diet and the development of overactive bladder: a longitudinal study in women. Neurourol Urodyn 23:204–210. doi:10.1007/s00192-012-1700-8 PubMedCrossRef

Parker-Autry CY, Gleason JL, Griffin RL, Markland AD, Richter HE (2014) Vitamin D deficiency is associated with increased fecal incontinence symptoms. Int Urogynecol J 25(11):1483–1489PubMedCentralPubMedCrossRef

Parker-Autry CY, Burgio KL, Richter HE (2012) Vitamin D status: a review with implications for the pelvic floor. Int Urogynecol J 23(11):1517–1526. doi:10.1007/s00192-012-1710-6 PubMedCentralPubMedCrossRef

10.

McKenna MJ (1992) Differences in vitamin D status between countries in young adults and the elderly. Am J Med 93(1):69–77PubMedCrossRef

11.

Van der Wielen RP, Lowik MR, van den Berg H et al (1995) Serum vitamin D concentrations among elderly people in Europe. Lancet 346(8969):207–210PubMedCrossRef

12.

Hanley DA, Davison KS (2005) Vitamin D insufficiency in North America. J Nutr 135(2):332–337PubMed

13.

Lips P, Hosking D, Lippuner K et al (2006) The prevalence of vitamin D inadequacy amongst women with osteoporosis: an international epidemiological investigation. J Intern Med 260(3):245–254. doi:10.1111/j.1365-2796.2006.01685.x PubMedCrossRef

14.

Bakhtiyarova S, Lesnyak O, Kyznesova N, Blankenstein MA, Lips P (2006) Vitamin D status among patients with hip fracture and elderly control subjects in Yekaterinburg. Russia Osteoporos Int 17(3):441–446. doi:10.1007/s00198-005-0006-9 PubMedCrossRef

15.

Erol M, Isman FK, Kucur M, Hacıbekiroglu lu M (2007) Evaluation of maternal D vitamin deficiency. Türk Pediatri Arsivi 42:29–32

16.

Van der Meer IM, Karamali NS, Boeke AJ, Lips P, Middelkoop BJ, Verhoeven I et al (2006) High prevalence of vitamin D deficiency in pregnant non-western women in The Hague, Netherlands. Am J Clin Nutr 84:350–353PubMed

17.

Crescioli C, Morelli A, Adorini L, Feruzzi P, Luconi M, Vannelli GB et al (2005) Human bladder as a novel target for vitamin D receptor ligands. J Clin Endocrinol Metab 90:962–972PubMedCrossRef

18.

Hong P, Leong M, Selzer V (1988) Uroflowmetric observation in pregnancy. Neurourol Urodyn 7:61–70. doi:10.1002/nau CrossRef

19.

Goldberg R, Kwon C, Gandhi S, Atkuru L, Sand P (2005) Urinary incontinence after multiple gestation and delivery: impact on quality of life. Int Urogynecol J Pelvic Floor Dysfunct 16:334–336PubMedCrossRef

Title: Association of antepartum vitamin D levels with postpartum pelvic floor muscle strength and symptoms
Authors: S. Aydogmus
S. Kelekci
H. Aydogmus
M. Demir
B. Yilmaz
R. Sutcu
Publication date: 01-08-2015
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 8/2015
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2671-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Association of antepartum vitamin D levels with postpartum pelvic floor muscle strength and symptoms

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2015

Procidentia in pregnancy: a systematic review and recommendations for practice

Comparison of two laparoscopic peritoneal vaginoplasty techniques in patients with Mayer–Rokitansky–Küster–Hauser syndrome

Transvaginal repair of stage III–IV cystocele using a lightweight mesh: safety and 36-month outcome

General or Spinal Anaesthetic for Vaginal Surgery in Pelvic Floor Disorders (GOSSIP): a feasibility randomised controlled trial

The correct episiotomy: does it exist? A cross-sectional survey of four public Israeli hospitals and review of the literature

Missing data frequency and correlates in two randomized surgical trials for urinary incontinence in women