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Association between striae gravidarum and pelvic floor dysfunction symptoms during pregnancy

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Abstract

Introduction and hypothesis

Striae gravidarum are linear atrophic scars appearing on the abdomen of pregnant women reported to be related to pregnancy-induced changes in the connective tissue. Pelvic floor distress symptoms are also known to be linked to connective tissue weakness. Given that common pathophysiological pathways may play a role in both striae gravidarum and pelvic floor dysfunction symptoms, we sought to examine whether there is a correlation between them during pregnancy.

Methods

A prospective observational study among third-trimester pregnant women who visited a tertiary medical center for routine pregnancy follow-up was conducted by using the Pelvic Floor Distress Inventory (PFDI-20) questionnaire to evaluate pelvic floor distress symptoms and the Davey method for evaluating striae gravidarum severity. Obstetrical characteristics as well as pelvic floor distress symptoms were compared between two groups according to the severity of striae gravidarum. Univariate analysis was carried out using appropriate tests; PFDI scores were compared between the groups using the Mann-Whitney test.

Results

Women with striae gravidarum were significantly older (31.06 vs. 28.83 years, p < 0.01), had a lower body mass index (27.5 vs. 30.98, p < 0.01), and gave birth to smaller neonates (3155 vs. 3389 g, p < 0.01). In addition, the overall and median PFDI-20 scores differed between the groups (with severe SG having the highest median score of 20 and those with milder SG having a score of 16 compared to 14 in those without SG). A distinct association between the PFDI-20 score and SG severity was not demonstrated (p = 0.63).

Conclusions

In our population, an association was demonstrated between pelvic floor distress symptoms and the presence of striae gravidarum. However, following a linear regression model, no statistically significant association between SG severity and total PFD-20 score was seen. Our findings strengthen the hypothesis of common connective tissue involvement in the pathophysiology of both conditions.

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Author notes

  1. Yael Lichtman and Amir Horev contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Soroka Medical Center, Beer-Sheva, Israel

    Yael Lichtman, Tamar Matyashov, Maayan Elnir Katz, Tamar Eshkoli & Adi Y. Weintraub

  2. Pediatric Dermatology Services, Soroka Medical Center, Beer-Sheva, Israel

    Amir Horev

  3. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Amir Horev & Adi Y. Weintraub

  4. Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University Medical School of Jerusalem, 12 Bayit Street, 91031, Jerusalem, Israel

    Reut Rotem

Authors
  1. Yael Lichtman
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  2. Amir Horev
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  4. Reut Rotem
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  7. Adi Y. Weintraub
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Contributions

Conceptualization and methodology: Y Lichtman, A Horev and AY Weintraub.

Data: Y Lichtman, T Matyashov and M Elnir Katz.

Software and formal analysis: R Rotem.

Original draft preparation Y Lichtman and A Horev.

Review and editing: AY Weintraub and T Eshkoli.

All authors have read and agreed to this version of the manuscript.

Corresponding author

Correspondence to Amir Horev.

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Ethical approval

The study received the approval of the Soroka institutional review board (SOR-0452171) on January 2019. The study was conducted after receiving approval of the Soroka institutional review board and was conducted in accordance with the Declaration of Helsinki and all appropriate amendments. All participants signed a written informed consent before entering the study.

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Lichtman, Y., Horev, A., Matyashov, T. et al. Association between striae gravidarum and pelvic floor dysfunction symptoms during pregnancy. Int Urogynecol J 33, 3441–3447 (2022). https://doi.org/10.1007/s00192-022-05249-8

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  • DOI: https://doi.org/10.1007/s00192-022-05249-8

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