Skip to main content

Advertisement

SpringerLink
Log in

Obstetric outcomes in women with vulvodynia or vaginismus

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Vulvodynia and vaginismus are common chronic vulvar pain disorders for which there is a paucity of literature on pregnancy outcomes of affected women. The study objective was to evaluate the associations between vulvodynia and vaginismus and obstetric outcomes.

Methods

We performed a retrospective cohort study including all birth-related admissions from 1999 to October 2015 extracted from the Healthcare Cost and Utilization Project-National Inpatient Sample from the United States. Women with vulvodynia or vaginismus were identified using the appropriate ICD-9 codes. Multivariate logistic regression models, adjusted for baseline maternal characteristics, were performed to evaluate the effect of vulvodynia and vaginismus on obstetrical and neonatal outcomes.

Results

A total of 879 obstetrical patients with vulvodynia or vaginismus were identified in our cohort of 13,792,544 patients admitted for delivery in US hospitals between 1999 and 2015, leading to an overall prevalence of 6 cases per 100,000 births. Between 1999 and 2015, the annual prevalence of vulvodynia or vaginismus rose from 2 to 16 cases per 100,000. Vulvodynia and vaginismus were associated with increased risks of eclampsia, chorioamnionitis, post-term pregnancy, cesarean delivery, instrumental vaginal delivery, blood transfusions, prolonged hospital stays, congenital anomalies and intrauterine growth restriction.

Conclusion

Vulvodynia and vaginismus in pregnancy appears underreported in pregnancy compared to reported population rates. Prevalence of reporting seems to have increased in the last decades and is associated with increased risks of maternal and newborn morbidities. Obstetrical caregivers should be aware of the underreporting of these conditions and the associated adverse effects when counseling obstetrical patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Vahia VN (2013) Diagnostic and statistical manual of mental disorders 5: a quick glance. Indian J Psychiatry 55(3):220–223

    Article  PubMed  PubMed Central  Google Scholar 

  2. Binik YM (2010) The DSM diagnostic criteria for vaginismus. Arch Sex Behav 39(2):278–291

    Article  PubMed  Google Scholar 

  3. Bergeron S et al (2020) Vulvodynia. Nat Rev Dis Primers 6(1):36

    Article  PubMed  Google Scholar 

  4. Möller L et al (2015) Reproduction and mode of delivery in women with vaginismus or localized provoked vestibulodynia: a Swedish register-based study. BJOG 122(3):329–334

    Article  PubMed  Google Scholar 

  5. Tourrilhes E et al (2019) Obstetric outcome of women with primary vaginismus. Pan Afr Med J 32:160

    PubMed  PubMed Central  Google Scholar 

  6. Nguyen RH, Stewart EG, Harlow BL (2012) A population-based study of pregnancy and delivery characteristics among women with vulvodynia. Pain Ther 1(1):2

    Article  PubMed  PubMed Central  Google Scholar 

  7. Goldsmith T et al (2009) Vaginismus as an independent risk factor for cesarean delivery. J Matern Fetal Neonatal Med 22(10):863–866

    Article  PubMed  Google Scholar 

  8. Research, A. F. H. and Quality (2017) HCUP databases. Healthcare cost and utilization project (HCUP). Agency for healthcare research and quality, Rockville, MD.

  9. Faye RB, Piraccini E (2021) Vulvodynia, in StatPearls. StatPearls Publishing LLC, Treasure Island (FL).

  10. Kadir ZS et al (2018) The neurobiology and psychiatric perspective of vaginismus: linking the pharmacological and psycho-social interventions. Curr Drug Targets 19(8):916–926

    Article  CAS  PubMed  Google Scholar 

  11. Arnold LD et al (2007) Assessment of vulvodynia symptoms in a sample of US women: a prevalence survey with a nested case control study. Am J Obstet Gynecol 196(2):128.e1-128.e6

    Article  PubMed  Google Scholar 

  12. Nguyen RH, Reese RL, Harlow BL (2015) Differences in pain subtypes between Hispanic and non-Hispanic white women with chronic vulvar pain. J Womens Health (Larchmt) 24(2):144–150

    Article  PubMed  Google Scholar 

  13. Drenth JJ et al (1996) Connections between primary vaginismus and procreation: some observations from clinical practice. J Psychosom Obstet Gynaecol 17(4):195–201

    Article  CAS  PubMed  Google Scholar 

  14. Hales CM et al (2018) Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007–2008 to 2015–2016. JAMA 319(16):1723–1725

    Article  PubMed  PubMed Central  Google Scholar 

  15. Neovius M, Janson A, Rössner S (2006) Prevalence of obesity in Sweden. Obes Rev 7(1):1–3

    Article  CAS  PubMed  Google Scholar 

  16. Gota CE, Kaouk S, Wilke WS (2015) Fibromyalgia and obesity: the association between body mass index and disability, depression, history of abuse, medications, and comorbidities. J Clin Rheumatol 21(6):289–295

    Article  PubMed  Google Scholar 

  17. Achour R et al (2019) Vaginismus and pregnancy: epidemiological profile and management difficulties. Psychol Res Behav Manag 12:137–143

    Article  PubMed  PubMed Central  Google Scholar 

  18. Linder N et al (2017) Post-term pregnancy is an independent risk factor for neonatal morbidity even in low-risk singleton pregnancies. Arch Dis Child Fetal Neonatal Ed 102(4):F286-f290

    Article  PubMed  Google Scholar 

  19. Osborne LM, Monk C (2013) Perinatal depression–the fourth inflammatory morbidity of pregnancy? Theory and literature review. Psychoneuroendocrinology 38(10):1929–1952

    Article  PubMed  PubMed Central  Google Scholar 

  20. Reed BD et al (2014) Factors associated with vulvodynia incidence. Obstet Gynecol 123(2 Pt 1):225–231

    Article  PubMed  PubMed Central  Google Scholar 

  21. Räisänen S et al (2014) Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002–2010 in Finland. BMJ Open 4(11):e004883

    Article  PubMed  PubMed Central  Google Scholar 

  22. Blumenfeld YJ et al (2015) Risk factors for prolonged postpartum length of stay following cesarean delivery. Am J Perinatol 32(9):825–832

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Pav H, Room 325, 5790 Cote-Des-Neiges Road, Montreal, QC, H3S 1Y9, Canada

    Sophie Baril & Haim Arie Abenhaim

  2. Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, QC, Canada

    Nicholas Czuzoj-Shulman & Haim Arie Abenhaim

Authors
  1. Sophie Baril
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicholas Czuzoj-Shulman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Haim Arie Abenhaim
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SB: contributed to study design; interpretation of data; drafting of manuscript; read and approved final version of manuscript. N C-S: data management; formal data analysis; revision of manuscript; read and approved final version of manuscript. HA: conception and design; acquisition of data; supervision of analyses; interpretation of data; critical revision of manuscript for important intellectual content; read and approved final version of manuscript.

Corresponding author

Correspondence to Haim Arie Abenhaim.

Ethics declarations

Conflict of interest

The authors report no conflict of interest. We had full control of all primary data and we agree to allow the Journal to review this data, if requested.

Research involving human participants

This study exclusively used data from an existing administrative database. These data were publicly available; hence, according to the Tri-Council Policy statement (2018), institutional review board approval was not required.

Informed consent

This study used publicly available data; hence, we did not personally obtain informed consent from study subjects. This would be the responsibility of the Agency for Healthcare Research and Quality (AHRQ), who sponsors the National Inpatient Sample.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baril, S., Czuzoj-Shulman, N. & Abenhaim, H.A. Obstetric outcomes in women with vulvodynia or vaginismus. Arch Gynecol Obstet 308, 471–477 (2023). https://doi.org/10.1007/s00404-022-06669-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-022-06669-z

Keywords

Search

Navigation