Pelvic floor muscle strength is low after giving birth if vitamin D deficient – March 2015

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

International Urogynecology Journal, March 2015
S. Aydogmus serpilaydogmus at gmail.com, S. Kelekci, H. Aydogmus, M. Demir, B. Yilmaz, R. Sutcu
1. Department of Gynaecology and Obstetrics, İzmir Katip Çelebi University School of Medicine, İzmir, Turkey
4. Ilica mah. Zeytin sok. No.20/20. 35320, Narlıdere, Izmir, Turkey
2. Department of Gynecology and Obstetrics, Izmir Atatürk Research and Training Hospital, Izmir, Turkey
3. Department of Biochemistry, İzmir Katip Çelebi University School of Medicine, İzmir, Turkey

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.

References

1. 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 CrossRef
2. 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 CrossRef
3. 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
4. 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 CrossRef
5. 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
6. 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 26:129–133 CrossRef
7. 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 CrossRef
8. 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):1483–1489 CrossRef
9. 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 CrossRef
10. McKenna MJ (1992) Differences in vitamin D status between countries in young adults and the elderly. Am J Med 93(1):69–77 CrossRef
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):207–210 CrossRef
12. Hanley DA, Davison KS (2005) Vitamin D insufficiency in North America. J Nutr 135(2):332–337
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 CrossRef
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 CrossRef
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 84:350–353
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 90:962–972 CrossRef
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 16:334–336 CrossRef

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