Spanish validation of the German pelvic floor questionnaire for pregnant and postpartum women

Objective This study translates and culturally adapts the German “Questionnaire for the Assessment of Pelvic Floor Disorders and Their Risk Factors during Pregnancy and Post Partum” into Spanish and evaluates its reliability, validity, and responsiveness in a Spanish population. Methods Translation/re‐translation and cultural adaptation were performed according to standardized guidelines for cross‐cultural adaptation of self‐report measures. A prospective study involving women in the early weeks of pregnancy was conducted for the validation process. Reliability was measured using Cronbach's alpha for internal consistency, and Cohen's kappa and intraclass correlation coefficient (ICC) for test–retest reproducibility. Construct validity was assessed by comparing median domain scores between women with and without bothersome symptoms using the Mann–Whitney U ‐test, and with a confirmatory factor analysis. Responsiveness was evaluated by comparing questionnaire responses from the first trimester, the third trimester, and 6 weeks postpartum using Wilcoxon signed‐rank test, and effect sizes I and II. Results During the translation and cultural adaptation process, a minor modification was made to more accurately define postpartum pain. The validation involved 228 pregnant women, of whom 176 (77%) completed the questionnaire again 6 weeks after delivery. The questionnaire showed good internal consistency, with most Cronbach's alpha values exceeding 0.70. Test–retest reliability for each item ranged from moderate (0.59) to very good agreement (1.00) and the total score ICC was above 0.90, indicating excellent reliability. The questionnaire discriminated significantly between women with and without bothersome symptoms and demonstrated responsiveness during pregnancy and postpartum. Conclusion The Spanish version of the questionnaire is a reliable, valid, and responsive instrument for assessing pelvic floor dysfunction during pregnancy and postpartum.