Pregnancy-Related Changes in Pelvic Organ Prolapse and Bowel Function: A Longitudinal Cohort Study

Introduction : Vaginal childbirth is an established risk factor for pelvic organ prolapse (POP) and obstructed defaecation (OD). However, emerging evidence suggests that physiological changes during pregnancy may independently predispose women to POP, regardless of delivery mode. Methods : This prospective longitudinal cohort sub-study utilized data from the Mater Queensland Family Cohort Pilot study (2018–2019). Data were collected at 24- and 36-weeks’ gestation, and at 6 weeks postpartum. Primary outcome measures included the Bristol Stool Chart, Constipation Assessment Scale, and Prolapse Questionnaire. Results : Among 419 women with a mean (± SD) age of 31 years (± 4.9), symptomatic POP was reported by 40.3% of participants, peaking at 36 weeks’ gestation (mean score 2.85 ± 0.07; 95% CI 2.70–2.99). POP scores increased from 24 weeks (2.38 ± 0.04; 95% CI 2.29–2.46) to 36 weeks, then decreased postpartum (2.17 ± 0.06; 95% CI 2.70–2.99). Although OD scores showed a fluctuating pattern, significant positive correlations were observed between POP and OD scores at all time points (p<0.01). No correlation between OD scores and Bristol stool classifications was found. Conclusion : Advancing pregnancy is significantly associated with increased POP symptoms, which reduce postpartum. Pregnancy itself contributes to POP development, independent of delivery mode. Despite no reported symptomatic OD, a significant relationship between POP and OD scores was observed.