Roman Maria Patricia, Ciortea Răzvan, Doumouchtsis Stergios K, Măluţan Andrei Mihai, Bucuri Carmen Elena, Oltean Oana Mihaela, Ormindean Cristina Mihaela, Suciu Viorela Elena, Nati Ionel Daniel, Rus Denisa, Mihu Dan
2nd Obstetrics and Gynecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania.
Department of Mother and Child, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Front Med (Lausanne). 2025 Jun 3;12:1510417. doi: 10.3389/fmed.2025.1510417. eCollection 2025.
Childbirth-related pelvic floor trauma is prevalent among primiparous women and can lead to significant physical and psychological consequences. While the impact of pelvic floor trauma on physical outcomes has been studied, the relationship between anxiety caused by such trauma and long-term patient-reported outcomes (PROs) such as vaginal symptoms, sexual function, and quality of life (QoL) remains underexplored. This study aims to fill this gap by investigating the association between anxiety induced by pelvic floor trauma during childbirth and these key PROs.
This prospective longitudinal cohort study analyzed data from 175 nulliparous women who delivered at term a singleton fetus in cephalic presentation and sustained some form of perineal trauma. Anxiety levels were assessed at two time points: during labor and at 12 months postpartum, using a single-item 10-point Likert scale. The other PROs were measured using the International Consultation on Incontinence Questionnaire-Vaginal Symptoms tool (ICIQ-VS).
Findings revealed that higher anxiety scores at birth were associated with elevated anxiety levels at 12 months postpartum and correlated significantly with increased vaginal symptoms, sexual symptoms, and QoL. Notably, while anxiety was linked to negative physical outcomes, higher anxiety scores were also associated with improved perceived QoL, suggesting the potential role of coping mechanisms in response to childbirth trauma as well as the need for future studies using more specialized anxiety tools.
The study underscores the intricate relationship between psychological distress and physical health outcomes in postpartum women. Addressing both anxiety and physical symptoms through personalized care strategies may enhance recovery and overall wellbeing. Future research should explore effective interventions to mitigate anxiety, evaluate resilience and improve PROs in this population.
分娩相关的盆底创伤在初产妇中很常见，并可能导致严重的身体和心理后果。虽然盆底创伤对身体结局的影响已得到研究，但这种创伤引起的焦虑与患者长期报告的结局（PROs）之间的关系，如阴道症状、性功能和生活质量（QoL），仍未得到充分探索。本研究旨在通过调查分娩时盆底创伤引起的焦虑与这些关键PROs之间的关联来填补这一空白。
这项前瞻性纵向队列研究分析了175名未生育妇女的数据，这些妇女足月分娩单胎头位胎儿并遭受了某种形式的会阴创伤。在两个时间点评估焦虑水平：分娩期间和产后12个月，使用单项10分李克特量表。使用国际尿失禁咨询委员会阴道症状工具（ICIQ-VS）测量其他PROs。
研究结果显示，分娩时较高的焦虑评分与产后（12个月时）焦虑水平升高相关，并且与阴道症状、性症状和生活质量的增加显著相关。值得注意的是，虽然焦虑与负面身体结局有关，但较高的焦虑评分也与改善的生活质量感知相关，这表明应对机制在应对分娩创伤中的潜在作用，以及未来使用更专业的焦虑工具进行研究的必要性。
该研究强调了产后妇女心理困扰与身体健康结局之间的复杂关系。通过个性化护理策略解决焦虑和身体症状可能会促进康复和整体幸福感。未来的研究应探索减轻焦虑的有效干预措施，评估复原力并改善该人群的PROs。
