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Objective <p>To identify postpartum pelvic floor dysfunction (PFD) risk factors and develop a predictive model.</p> Methods <p>A retrospective study was conducted on 180 postpartum women who met predefined criteria at the postpartum follow-up clinic of Yangzhi Rehabilitation Hospital between January 2023 and December 2024. Clinical characteristics and pelvic floor ultrasound indicators were retrieved. PFD was defined as presence of stress urinary incontinence (SUI) or cystocele. Univariate and multivariate logistic regression strategies were employed to identify independent predictors, which were integrated into a nomogram. Model performance was evaluated via concordance index (C-index), calibration curves, and decision curve analysis (DCA).</p> Results <p>Among 180 participants, 105 had PFD and 75 were controls. Multivariate analysis confirmed three ultrasound indices as independent predictors: resting levator plate angle (OR = 0.934, <i>P</i> = 0.044), valsalva levator plate angle (OR = 1.075, <i>P</i> = 0.007), and bladder neck mobility (OR = 1.201, <i>P</i> &lt; 0.001). Only bladder neck mobility weakly correlated with SUI status (<i>r</i> = 0.180, <i>P</i> = 0.016). The nomogram showed excellent discriminative power (C-index = 0.841, 95% CI:0.785–0.897) and calibration; DCA verified its superior clinical applicability.</p> Conclusion <p>This ultrasound-based nomogram serves as a valuable adjunct for postpartum PFD risk stratification, especially for primiparous women. This model provides a reference for targeted screening and early rehabilitation planning, with final clinical decisions requiring comprehensive symptomatic assessment.</p>

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Utility of ultrasound-based nomogram for predicting postpartum pelvic floor dysfunction: stress urinary incontinence and cystocele

  • 期刊论文

  • 发表日期：

    2026年2月16日

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  • Yan Zhang,
  • Xiji Zhou,
  • Zhenghong Wu,
  • Yan Qi,
  • Qi Ma

摘要

Objective

To identify postpartum pelvic floor dysfunction (PFD) risk factors and develop a predictive model.

Methods

A retrospective study was conducted on 180 postpartum women who met predefined criteria at the postpartum follow-up clinic of Yangzhi Rehabilitation Hospital between January 2023 and December 2024. Clinical characteristics and pelvic floor ultrasound indicators were retrieved. PFD was defined as presence of stress urinary incontinence (SUI) or cystocele. Univariate and multivariate logistic regression strategies were employed to identify independent predictors, which were integrated into a nomogram. Model performance was evaluated via concordance index (C-index), calibration curves, and decision curve analysis (DCA).

Results

Among 180 participants, 105 had PFD and 75 were controls. Multivariate analysis confirmed three ultrasound indices as independent predictors: resting levator plate angle (OR = 0.934, P = 0.044), valsalva levator plate angle (OR = 1.075, P = 0.007), and bladder neck mobility (OR = 1.201, P < 0.001). Only bladder neck mobility weakly correlated with SUI status (r = 0.180, P = 0.016). The nomogram showed excellent discriminative power (C-index = 0.841, 95% CI:0.785–0.897) and calibration; DCA verified its superior clinical applicability.

Conclusion

This ultrasound-based nomogram serves as a valuable adjunct for postpartum PFD risk stratification, especially for primiparous women. This model provides a reference for targeted screening and early rehabilitation planning, with final clinical decisions requiring comprehensive symptomatic assessment.