Episiotomy and perineal trauma during childbirth in primiparous women: associations with anxiety, quality of life, vaginal and sexual symptoms in the first year postpartum

IntroductionChildbirth-related pelvic floor trauma is prevalent among primiparous women and can lead to significant physical and psychological consequences. While the impact of pelvic floor trauma on physical outcomes has been studied, the relationship between anxiety caused by such trauma and long-...

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Main Authors: Maria Patricia Roman, Răzvan Ciortea, Stergios K. Doumouchtsis, Andrei Mihai Măluţan, Carmen Elena Bucuri, Oana Mihaela Oltean, Cristina Mihaela Ormindean, Viorela Elena Suciu, Ionel Daniel Nati, Denisa Rus, Dan Mihu
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Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1510417/full
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author Maria Patricia Roman
Maria Patricia Roman
Răzvan Ciortea
Răzvan Ciortea
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Andrei Mihai Măluţan
Andrei Mihai Măluţan
Carmen Elena Bucuri
Carmen Elena Bucuri
Oana Mihaela Oltean
Cristina Mihaela Ormindean
Cristina Mihaela Ormindean
Viorela Elena Suciu
Ionel Daniel Nati
Ionel Daniel Nati
Denisa Rus
Dan Mihu
Dan Mihu
author_facet Maria Patricia Roman
Maria Patricia Roman
Răzvan Ciortea
Răzvan Ciortea
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Andrei Mihai Măluţan
Andrei Mihai Măluţan
Carmen Elena Bucuri
Carmen Elena Bucuri
Oana Mihaela Oltean
Cristina Mihaela Ormindean
Cristina Mihaela Ormindean
Viorela Elena Suciu
Ionel Daniel Nati
Ionel Daniel Nati
Denisa Rus
Dan Mihu
Dan Mihu
author_sort Maria Patricia Roman
collection DOAJ
description IntroductionChildbirth-related pelvic floor trauma is prevalent among primiparous women and can lead to significant physical and psychological consequences. While the impact of pelvic floor trauma on physical outcomes has been studied, the relationship between anxiety caused by such trauma and long-term patient-reported outcomes (PROs) such as vaginal symptoms, sexual function, and quality of life (QoL) remains underexplored. This study aims to fill this gap by investigating the association between anxiety induced by pelvic floor trauma during childbirth and these key PROs.MethodsThis prospective longitudinal cohort study analyzed data from 175 nulliparous women who delivered at term a singleton fetus in cephalic presentation and sustained some form of perineal trauma. Anxiety levels were assessed at two time points: during labor and at 12 months postpartum, using a single-item 10-point Likert scale. The other PROs were measured using the International Consultation on Incontinence Questionnaire-Vaginal Symptoms tool (ICIQ-VS).ResultsFindings revealed that higher anxiety scores at birth were associated with elevated anxiety levels at 12 months postpartum and correlated significantly with increased vaginal symptoms, sexual symptoms, and QoL. Notably, while anxiety was linked to negative physical outcomes, higher anxiety scores were also associated with improved perceived QoL, suggesting the potential role of coping mechanisms in response to childbirth trauma as well as the need for future studies using more specialized anxiety tools.ConclusionThe study underscores the intricate relationship between psychological distress and physical health outcomes in postpartum women. Addressing both anxiety and physical symptoms through personalized care strategies may enhance recovery and overall wellbeing. Future research should explore effective interventions to mitigate anxiety, evaluate resilience and improve PROs in this population.
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spelling doaj-art-4ace395561054e1fae25ce20c772e8af2025-08-20T03:19:24ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.15104171510417Episiotomy and perineal trauma during childbirth in primiparous women: associations with anxiety, quality of life, vaginal and sexual symptoms in the first year postpartumMaria Patricia Roman0Maria Patricia Roman1Răzvan Ciortea2Răzvan Ciortea3Stergios K. Doumouchtsis4Stergios K. Doumouchtsis5Stergios K. Doumouchtsis6Stergios K. Doumouchtsis7Stergios K. Doumouchtsis8Andrei Mihai Măluţan9Andrei Mihai Măluţan10Carmen Elena Bucuri11Carmen Elena Bucuri12Oana Mihaela Oltean13Cristina Mihaela Ormindean14Cristina Mihaela Ormindean15Viorela Elena Suciu16Ionel Daniel Nati17Ionel Daniel Nati18Denisa Rus19Dan Mihu20Dan Mihu212nd Obstetrics and Gynecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, RomaniaDepartment of Mother and Child, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania2nd Obstetrics and Gynecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, RomaniaDepartment of Mother and Child, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, RomaniaDepartment of Obstetrics and Gynecology, Epsom and St. Helier University Hospitals NHS Trust, Epsom, United KingdomSt. George’s University of London, Cranmer Terrace, London, United KingdomLaboratory of Experimental Surgery and Surgical Research “N.S. Christeas,” National and Kapodistrian University of Athens, Medical School, Athens, GreeceSchool of Medicine, American University of the Caribbean, Cupecoy, Sint MaartenSchool of Medicine, Ross University, Miramar, FL, United States2nd Obstetrics and Gynecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, RomaniaDepartment of Mother and Child, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, RomaniaDepartment of Mother and Child, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, RomaniaMilitary Emergency Hospital “Dr. Constantin Papilian”, Cluj-Napoca, RomaniaDepartment of Mother and Child, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania2nd Obstetrics and Gynecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, RomaniaDepartment of Mother and Child, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, RomaniaDepartment of Mother and Child, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania2nd Obstetrics and Gynecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, RomaniaDepartment of Mother and Child, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania2nd Obstetrics and Gynecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, Romania2nd Obstetrics and Gynecology Clinical Section, Cluj County Emergency Clinical Hospital, Cluj-Napoca, RomaniaDepartment of Mother and Child, “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, RomaniaIntroductionChildbirth-related pelvic floor trauma is prevalent among primiparous women and can lead to significant physical and psychological consequences. While the impact of pelvic floor trauma on physical outcomes has been studied, the relationship between anxiety caused by such trauma and long-term patient-reported outcomes (PROs) such as vaginal symptoms, sexual function, and quality of life (QoL) remains underexplored. This study aims to fill this gap by investigating the association between anxiety induced by pelvic floor trauma during childbirth and these key PROs.MethodsThis prospective longitudinal cohort study analyzed data from 175 nulliparous women who delivered at term a singleton fetus in cephalic presentation and sustained some form of perineal trauma. Anxiety levels were assessed at two time points: during labor and at 12 months postpartum, using a single-item 10-point Likert scale. The other PROs were measured using the International Consultation on Incontinence Questionnaire-Vaginal Symptoms tool (ICIQ-VS).ResultsFindings revealed that higher anxiety scores at birth were associated with elevated anxiety levels at 12 months postpartum and correlated significantly with increased vaginal symptoms, sexual symptoms, and QoL. Notably, while anxiety was linked to negative physical outcomes, higher anxiety scores were also associated with improved perceived QoL, suggesting the potential role of coping mechanisms in response to childbirth trauma as well as the need for future studies using more specialized anxiety tools.ConclusionThe study underscores the intricate relationship between psychological distress and physical health outcomes in postpartum women. Addressing both anxiety and physical symptoms through personalized care strategies may enhance recovery and overall wellbeing. Future research should explore effective interventions to mitigate anxiety, evaluate resilience and improve PROs in this population.https://www.frontiersin.org/articles/10.3389/fmed.2025.1510417/fullchildbirth perineal traumaepisiotomyanxietyICIQ-VSpatient-reported outcomesvaginal symptoms
spellingShingle Maria Patricia Roman
Maria Patricia Roman
Răzvan Ciortea
Răzvan Ciortea
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Stergios K. Doumouchtsis
Andrei Mihai Măluţan
Andrei Mihai Măluţan
Carmen Elena Bucuri
Carmen Elena Bucuri
Oana Mihaela Oltean
Cristina Mihaela Ormindean
Cristina Mihaela Ormindean
Viorela Elena Suciu
Ionel Daniel Nati
Ionel Daniel Nati
Denisa Rus
Dan Mihu
Dan Mihu
Episiotomy and perineal trauma during childbirth in primiparous women: associations with anxiety, quality of life, vaginal and sexual symptoms in the first year postpartum
Frontiers in Medicine
childbirth perineal trauma
episiotomy
anxiety
ICIQ-VS
patient-reported outcomes
vaginal symptoms
title Episiotomy and perineal trauma during childbirth in primiparous women: associations with anxiety, quality of life, vaginal and sexual symptoms in the first year postpartum
title_full Episiotomy and perineal trauma during childbirth in primiparous women: associations with anxiety, quality of life, vaginal and sexual symptoms in the first year postpartum
title_fullStr Episiotomy and perineal trauma during childbirth in primiparous women: associations with anxiety, quality of life, vaginal and sexual symptoms in the first year postpartum
title_full_unstemmed Episiotomy and perineal trauma during childbirth in primiparous women: associations with anxiety, quality of life, vaginal and sexual symptoms in the first year postpartum
title_short Episiotomy and perineal trauma during childbirth in primiparous women: associations with anxiety, quality of life, vaginal and sexual symptoms in the first year postpartum
title_sort episiotomy and perineal trauma during childbirth in primiparous women associations with anxiety quality of life vaginal and sexual symptoms in the first year postpartum
topic childbirth perineal trauma
episiotomy
anxiety
ICIQ-VS
patient-reported outcomes
vaginal symptoms
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1510417/full
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