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Impact of vaginal parity and aging on the architectural design of pelvic floor muscles

Overview of attention for article published in American Journal of Obstetrics & Gynecology, March 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (82nd percentile)
  • Above-average Attention Score compared to outputs of the same age and source (59th percentile)

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1 news outlet
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1 Facebook page

Citations

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65 Dimensions

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131 Mendeley
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Title
Impact of vaginal parity and aging on the architectural design of pelvic floor muscles
Published in
American Journal of Obstetrics & Gynecology, March 2016
DOI 10.1016/j.ajog.2016.02.033
Pubmed ID
Authors

Marianna Alperin, Mark Cook, Lori J. Tuttle, Mary C. Esparza, Richard L. Lieber

Abstract

Vaginal delivery and aging are key risk factors for pelvic floor muscle dysfunction, which is a critical component of pelvic floor disorders. However, alterations in the PFM intrinsic structure due to childbirth and aging that lead to muscle dysfunction remain elusive. To determine the impact of vaginal deliveries and aging on human cadaveric PFM architecture, the strongest predictor of active muscle function. Coccygeus, iliococcygeus and pubovisceralis were obtained from younger, ≤ 51 years, vaginally nulliparous (N=5) and vaginally parous (N=6), and older, >51 years, vaginally nulliparous (N=6) and vaginally parous (N=6) donors without history of PFDs. Architectural parameters, predictive of muscle's excursion and force-generating capacity, were determined using validated methods. Intramuscular collagen content was quantified by hydroxyproline assay. Main effects of parity and aging and the interactions were determined using two-way ANOVA, with Tukey's post-hoc testing with significance level of 0.05. The mean age of younger and older donors differed by ∼40 years (P=0.001), but was similar between nulliparous and parous donors within each age group (P>0.9). Median parity was 2 (range 1-3) in younger and older vaginally parous groups, P=0.7. The main impact of parity was increased fiber length in the more proximal coccygeus (P=0.03), and iliococcygeus (P=0.04). Aging changes manifested as decreased physiological cross sectional area across all pelvic floor muscles, P<0.05, which substantially exceeded the age-related decline in muscle mass. Physiological cross sectional area was lower in younger vaginally parous, compared to younger vaginally nulliparous pelvic floor muscles, however the differences did not reach statistical significance. Pelvic floor muscles' collagen content was not altered by parity, but increased dramatically with aging, P<0.05. Increased fiber length in more proximal pelvic floor muscles likely represents an adaptive response to the chronically increased load placed on these muscles by the displaced apical structures, presumably as a consequence of vaginal delivery. In younger specimens, a consistent trend towards decrease in force generating capacity of all pelvic floor muscles in parous group suggests a potential mechanism for clinically identified pelvic floor muscle weakness in vaginally parous women. The substantial decrease in predicted muscle force production and fibrosis with aging represent likely mechanisms for the pelvic floor muscle dysfunction in older women.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 131 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 131 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 21 16%
Student > Master 18 14%
Student > Bachelor 17 13%
Researcher 11 8%
Student > Doctoral Student 10 8%
Other 28 21%
Unknown 26 20%
Readers by discipline Count As %
Medicine and Dentistry 39 30%
Nursing and Health Professions 21 16%
Engineering 17 13%
Biochemistry, Genetics and Molecular Biology 4 3%
Neuroscience 4 3%
Other 9 7%
Unknown 37 28%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 September 2016.
All research outputs
#3,561,561
of 25,374,917 outputs
Outputs from American Journal of Obstetrics & Gynecology
#3,270
of 13,307 outputs
Outputs of similar age
#53,952
of 313,484 outputs
Outputs of similar age from American Journal of Obstetrics & Gynecology
#77
of 189 outputs
Altmetric has tracked 25,374,917 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 13,307 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.8. This one has done well, scoring higher than 75% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 313,484 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 82% of its contemporaries.
We're also able to compare this research output to 189 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 59% of its contemporaries.