Association between neonatal birthweight and maternal vaginal wall prolapse: a retrospective analysis of postpartum women.

Objective: To investigate the association between neonatal birthweight (BW) and the maternal risk of anterior and posterior vaginal wall prolapse in the postpartum period. Methods: This retrospective cross-sectional study included 864 postpartum women undergoing routine follow-ups after delivery. Participants were categorized into quartiles according to BW. Multivariate logistic regression models were applied to evaluate the association between BW and moderate-to-severe vaginal wall prolapse [Pelvic Organ Prolapse Quantification (POP-Q), POP-Q stage ≥ II], sequentially adjusting for maternal age, parity, mode of delivery, and plurality. Restricted cubic spline (RCS) analyses were used to examine potential non-linear relationships, accompanied by subgroup and sensitivity analyses. Results: In the fully adjusted model, each 1 kg increase in BW was associated with a 71% higher risk of posterior vaginal wall prolapse (OR = 1.71, 95% CI: 1.18-2.53, Conclusion: Higher BW is an independent risk factor for maternal posterior vaginal wall prolapse, showing both dose-dependent and threshold effects. The results suggest that women who deliver larger babies may require enhanced postpartum pelvic floor evaluation and follow-up management, and further prospective studies are needed to explore the long-term implications of these findings on pelvic floor health.