The Program Project, Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery uses mixed methods research to study the influence of intra-abdominal pressure, physical activity and strength on pelvic floor support and symptoms and the cultural context in which women experience those changes. Up to 1 in 7 women undergoes surgery for pelvic organ prolapse or urinary incontinence in her lifetime. Despite the high prevalence and high cost of treating these disorders, urgently needed prevention strategies are scare, reflecting the current state of knowledge. Supported by an exceptional institutional environment and a robust research infrastructure, this Program Project is uniquely positioned to address its primary hypothesis that understanding factors associated with pelvic floor support and symptoms after the first vaginal delivery will lead to developing and testing novel prevention strategies. In this mixed methods research, the core group of 11 investigators from 4 University of Utah colleges will build on the rich tradition of excellence at the University of Utah in research involving pregnant or postpartum women, bioengineering, exercise science, qualitative research, and pelvic floor disorders, to tackle together problems that continue to plague research in pelvic floor disorders. The scope of this project is relevant to the portfolio of the Gynecologic Health and Disease Branch within NICHD, which specifically includes pelvic floor disorders.
The aim of this Program is to lay the groundwork for humanistic evidence-based interventions that mitigate the impact of vaginal delivery on deteriorations in pelvic floor support and symptoms with an eye toward early detection, prevention of future bothersome pelvic floor disorders, and provision of culturally sensitive clinical care and self-care resources. The Program will also promote career development of multi-disciplinary trainees in pelvic floor disorders and serve as a resource for future research collaboration in the prevention of pelvic floor disorders. To accomplish this aim, the Program structure includes 3 Cores, Administrative (A), Biostatistics (B) and Clinical Coordination (C), which in turn will support 3 Projects: Project 1: Intra-abdominal pressure and postpartum pelvic floor support and symptoms; Project 2: Physical activity, inactivity, and fitness: Impact on postpartum pelvic floor support and symptoms; and Project 3: The cultural context of postpartum pelvic floor support following vaginal delivery: a comparative ethnographic analysis of Mexican-American and Euro-American women. The Program creates a synergistic team of committed researchers and weaves their skills, ideas, and resources into an optimal environment in which to make discoveries that will improve the health of women.

Public Health Relevance

The goal of this Program Project is to further the understanding of postpartum pelvic floor support and pelvic floor symptoms in women after their first vaginal birth in order to expand preventions that will decrease the burden women suffer from pelvic floor disorders. The Program creates a synergistic team of committed researchers and weaves their skills, ideas, and resources into an optimal environment in which to make discoveries that will improve the health of childbearing women.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Program Projects (P01)
Project #
5P01HD080629-04
Application #
9522837
Study Section
Special Emphasis Panel (ZHD1)
Program Officer
Mazloomdoost, Donna
Project Start
2015-07-27
Project End
2020-06-30
Budget Start
2018-07-01
Budget End
2019-06-30
Support Year
4
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of Utah
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
009095365
City
Salt Lake City
State
UT
Country
United States
Zip Code
84112
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Hsu, Yvonne; Hitchcock, Robert; Niederauer, Stefan et al. (2018) Variables Affecting Intra-abdominal Pressure During Lifting in the Early Postpartum Period. Female Pelvic Med Reconstr Surg 24:287-291
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de Gennaro, Johanna Day; de Gennaro, Claire K; Shaw, Janet M et al. (2017) The Relationship Between Intra-Abdominal Pressure and Body Acceleration During Exercise. Female Pelvic Med Reconstr Surg :
Nygaard, Ingrid E; Clark, Erin; Clark, Lauren et al. (2017) Physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery: a protocol for a mixed-methods prospective cohort study. BMJ Open 7:e014252
Shaw, Janet M; Nygaard, Ingrid E (2017) Role of chronic exercise on pelvic floor support and function. Curr Opin Urol 27:257-261
Nygaard, Ingrid E; Shaw, Janet M (2016) Physical activity and the pelvic floor. Am J Obstet Gynecol 214:164-171