Diabetes mellitus in pregnancy does not delay postpartum pelvic floor recovery

Pelvic floor dysfunction (PFD) symptoms are prevalent during pregnancy, however they are mostly reversible postpartum. Diabetes mellitus (DM) and pre-diabetic conditions, such as insulin resistance and impaired fasting glucose, have been found to be a risk factor for PFD in non-pregnant women. Therefore, it has been hypothesized that PFD symptoms may be more prevalent in women with gestational or pre-gestational DM and that there may be a slower spontaneous postpartum recovery of PFD symptoms. We aimed to determine the impact of DM on PFD symptoms recovery. We conducted a prospective cohort study of women who gave birth at a tertiary medical center in Israel. Women who have consented completed the “Pelvic Floor Distress Inventory-20” (PFDI-20), a condition specific questionnaire developed to measure quality-of-life and the extent of pelvic floor injury. The PFDI-20 was completed during the third trimester of pregnancy or immediately after delivery, and again three months postpartum. Clinical and obstetrical characteristics were retrieved from the participants' medical records. A total of 192 women have completed both questionnaires and were divided into DM group (n=66) and control group (n=126). We found a significant difference between PFD during pregnancy, and PFD three months postpartum (P<0.001). This difference remained consistent in all components of the PFDI-20: pelvic organ prolapse distress (P<0.001), colorectal and anal dysfunction (P=0.01) and urinary dysfunction (P<0.001). No significant difference was noted in the extent of recovery of PFD symptoms between women with DM and the control group (P=0.31). There is a clinical and statistically significant spontaneous recovery of PFD symptoms in the postpartum period. Diabetes mellitus in pregnancy does not delay the pelvic floor recovery postpartum.