ArticleAmerican journal of obstetrics and gynecology2025
Racial differences in the levator ani muscle and levator hiatus in individuals of reproductive age.
Article in American journal of obstetrics and gynecology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Documentation of Stigmatizing Language in Electronic Health Records and Birth Outcomes.Health equity · 2025Article
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6 authors.
Funding
Abstract
backgroundMost studies on pelvic floor muscle morphology (dimensions, shape) and its relationship with patient characteristic risk factors of pelvic floor dysfunction (demographics, medical history) have largely pertained to White individuals with vaginas. There is a need to establish normative data on pelvic floor muscle anatomy and identify morphological differences in racially diverse cohorts that may play a role in racial differences in the prevalence and pathophysiology of pelvic floor dysfunction.
objectiveThis study aimed to compare levator ani muscle thickness and levator hiatal morphology and their association with patient characteristics, between asymptomatic Black and White women-identifying individuals with a vagina of reproductive age. STUDY
designIn this dual-site retrospective study, pelvic magnetic resonance images of asymptomatic individuals with a vagina aged 18 to 50 years with normal pelvic anatomy-defined as normal gastrointestinal, genitourinary, or reproductive systems-were collected and categorized by self-reported race (Black, White). All individuals were imaged in the axial plane at rest in the supine position for medical indications. From these images, the levator ani muscle thickness and levator hiatal dimensions were measured. The levator hiatal area was traced to create 2-dimensional models of levator hiatal shape. Statistical shape modeling with principal component analysis was performed to quantify levator hiatal shape given by principal component scores. One-way multivariate and univariate analysis of covariance tests evaluated racial differences in levator ani muscle and levator hiatal measures with adjustments for age, body mass index, and parity. Spearman rank correlation with Fisher's z transformation tests quantified and compared correlations between patient characteristics and levator ani muscle and levator hiatal measures by racial group.
resultsA total of 112 participants were analyzed, with 59 Black and 53 White individuals. The Black cohort, compared to the White cohort, had a larger levator hiatal area (difference, 1.31 cm
conclusionAfter controlling for age, body mass index, and parity, larger levator hiatal dimensions and a more ovular, narrower, U-shaped levator hiatus were observed in Black individuals compared to White individuals. Future longitudinal studies are necessary to gain further insight into causative mechanisms for racial morphological variability in pelvic floor muscles that may contribute to racial disparities in pelvic floor dysfunction risk.
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