? Project 1 One in four women has moderate to severe symptoms of some type of pelvic floor disorder and up to 1 in 7 undergo surgery for these conditions in her lifetime. Associations between vaginal parity, pelvic organ prolapse and pelvic floor symptoms are well established; for many women, the stage for future pelvic floor disorders is set with the first vaginal delivery, yet we know little about how to maximize recovery following this seminal event. This knowledge gap limits developing strategies to modify risks in order to prevent deterioration of pelvic floor support and symptoms after vaginal delivery. Further research that provides insight into the earliest onset of the pathogenic process is needed. Intra-abdominal pressure (IAP), the focus of Project 1, is a direct measure of the forces experienced by the pelvic floor but has rarely been studied except in limited clinical settings. Our group has developed and tested a novel intra-vaginal transducer that measures IAP and wirelessly transmits the data to a small, pager-like data storage device. In this project, we plan to use this system to study how IAP impacts two primary outcomes at 1 year postpartum: 1) pelvic floor support and 2) pelvic floor symptoms. The scope of this project is relevant to NICHD's described mission, to ensure that ?women suffer no harmful effects from reproductive processes?, and specifically addresses pelvic floor disorders, as emphasized in the portfolio of the Gynecologic Health and Disease Branch. This project will use the Primiparous Cohort established by the Clinical Coordination Core to achieve these aims:
Aim 1 : Determine whether IAP measured at 8 weeks postpartum during a) lifting and b) abdominal muscle endurance testing predicts pelvic floor support and symptoms 1 year postpartum.
Aim 2 : Determine whether IAP measured for one week during daily life at 6 months postpartum predicts pelvic floor support and symptoms 1 year postpartum. Exploratory Aim 3: Determine whether measures of muscular fitness modify the effect of IAP during lifting on pelvic floor support at 1 year postpartum. Translational aim: Using data from Aim 2 of this Project and Project 2, in which physical activity is measured using accelerometry for a 7 day period at 6 months postpartum, explore the relationships between data obtained from the vaginal pressure sensor and wrist-worn accelerometry.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Program Projects (P01)
Project #
1P01HD080629-01A1
Application #
8931406
Study Section
Special Emphasis Panel (ZHD1-DSR-L (IN))
Project Start
Project End
Budget Start
2015-07-27
Budget End
2016-06-30
Support Year
1
Fiscal Year
2015
Total Cost
$167,753
Indirect Cost
$55,167
Name
University of Utah
Department
Type
DUNS #
009095365
City
Salt Lake City
State
UT
Country
United States
Zip Code
84112
Shaw, Janet M; Johnson, Danielle D; Nygaard, Ingrid E (2018) Engaging Undergraduate Kinesiology Students in Clinically-Based Research. Quest 70:292-303
Saltzman, Hanna M; Egger, Marlene J; Bardsley, Tyler et al. (2018) Differences in Pelvic Floor Symptoms During Pregnancy Between Hispanic and Non-Hispanic White Women. Female Pelvic Med Reconstr Surg :
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
Clark, Lauren; Birkhead, Ana Sanchez; Fernandez, Cecilia et al. (2017) A Transcription and Translation Protocol for Sensitive Cross-Cultural Team Research. Qual Health Res 27:1751-1764
Niederauer, Stefan; de Gennaro, Johanna; Nygaard, Ingrid et al. (2017) Development of a novel intra-abdominal pressure transducer for large scale clinical studies. Biomed Microdevices 19:80
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