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预防医学  2022, Vol. 34 Issue (9): 959-963    DOI: 10.19485/j.cnki.issn2096-5087.2022.09.020
  妇幼保健 本期目录 | 过刊浏览 | 高级检索 |
35岁及以上产妇产后压力性尿失禁的影响因素分析
汪柏云, 陈晓运, 胡春仙, 吴秋楠
杭州市妇产科医院产科,浙江 杭州 310008
Factors affecting postpartum stress urinary incontinence among lying-in women at ages of 35 years and older
WANG Baiyun, CHEN Xiaoyun, HU Chunxian, WU Qiunan
Department of Obstetrics, Hangzhou Obstetrics and Gynecology Hospital, Hangzhou, Zhejiang 310008, China
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摘要 目的 探讨35岁及以上产妇产后压力性尿失禁(PSUI)的影响因素,为预防PSUI提供参考。方法 于2021年1月—2022年4月,采用方便抽样法抽取在杭州市妇产科医院行产后检查的≥35岁产妇为调查对象,收集人口学信息、分娩方式、新生儿出生体重、腹直肌分离、盆底肌力损伤和盆底肌训练情况等资料,采用国际尿失禁咨询委员会尿失禁问卷简表评估PSUI发生情况;采用多因素logistic回归模型分析≥35岁产妇PSUI的影响因素。结果 发放问卷230份,回收有效问卷226份,回收有效率为98.26%。产妇年龄为(37.30±2.11)岁。孕前BMI以18.5~<24.0 kg/m2为主,171人占75.66%。产后BMI≥24.0 kg/m2 29人,占12.83%。分娩孕周≥37周201人,占88.94%。阴道分娩105人,占46.46%。新生儿出生体重≥4 000 g 20人,占8.85%。腹直肌分离149例,占65.93%;盆底肌力损伤154例,占68.14%。发生PSUI 57例,发生率为25.22%。多因素logistic回归分析结果显示,阴道分娩(OR=4.061,95%CI:2.124~7.763)、产后BMI≥24 kg/m2OR=1.903,95%CI:1.275~3.288)、新生儿出生体重≥4 000 g(OR=2.108,95%CI:1.420~4.135)、腹直肌分离(OR=1.487,95%CI:1.110~2.169)和盆底肌力损伤(OR=2.924,95%CI:1.726~4.803)是≥35岁产妇发生PSUI的危险因素;坚持盆底肌训练(OR=0.410,95%CI:0.216~0.780)是≥35岁产妇发生PSUI的保护因素。结论 PSUI的发生与产妇分娩方式、产后BMI、新生儿出生体重、腹直肌分离和盆底肌力损伤等因素有关,合理控制体重、积极开展盆底肌训练有助于预防PSUI的发生。
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汪柏云
陈晓运
胡春仙
吴秋楠
关键词 压力性尿失禁高龄产妇盆底肌力损伤    
AbstractObjective To investigate the factors affecting postpartum stress urinary incontinence (PSUI) among lying-in women at ages of 35 years and older, so as to provide insights into PSUI prevention. Methods Lying-in women at ages of 35 years and older receiving postpartum examinations were sampled using a convenient sampling method from Hangzhou Obstetrics and Gynecology Hospital during the period from January 2021 to April 2022. Participants' demographic data, type of delivery, birth weight, diastasis recti abdominis, pelvic floor muscle strength injury, pelvic floor muscle training were collected, and the development of PSUI was evaluated using the International Consultation on Incontinence modular questionnaire. The factors affecting the development of PSUI were identified among lying-in women at ages of 35 years and older using a multivariable logistic regression model. Results A total of 230 questionnaires were allocated, and 226 valid questionnaires were recovered, with an effective recovery rate of 98.26%. The lying-in women had a mean age of (37.30±2.11) years, and 75.66% had a pre-pregnancy body mass index (BMI) of 18.5 to 24.0 kg/m2. There were 29 women with postpartum BMI of 24.0 kg/m2 and greater (12.83%), 201 women with gestational weeks of 37 weeks and greater at delivery (88.94%), 105 women with vaginal delivery (46.46%), 20 women with neonatal birth weights of 4 000 g and higher (8.85%), 149 women with diastasis recti abdominis (65.93%), 154 women with pelvic floor muscle strength injury (68.14%). The prevalence of PSUI was 25.22% among the study subjects. Multivariable logistic regression analysis showed that vaginal delivery (OR=4.061, 95%CI: 2.124-7.763), postpartum BMI of 24 kg/m2 and higher (OR=1.903, 95%CI: 1.275-3.288), neonatal birth weight of 4 000 g and higher (OR=2.108, 95%CI: 1.420-4.135), diastasis recti abdominis (OR=1.487, 95%CI: 1.110-2.169) and pelvic floor muscle strength injury (OR=2.924, 95%CI: 1.726-4.803) were risk factors for PSUI among lying-in women at ages of 35 years and older, and pelvic floor muscle training was a protective factor for PSUI among lying-in women at ages of 35 years and older (OR=0.410, 95%CI: 0.216-0.780). Conclusions The development of PSUI correlates with the type of delivery, postpartum BMI, neonatal birth weight, diastasis recti abdominis and pelvic floor muscle strength injury among lying-in women. Reasonable weight control and active pelvic floor muscle training may facilitate the prevention of PSUI.
Key wordsstress urinary incontinence    elderly pregnant woman    pelvic floor muscle strength injury
收稿日期: 2022-06-17      修回日期: 2022-07-21     
中图分类号:  R711.5  
作者简介: 汪柏云,本科,护师,主要从事妇幼保健工作
引用本文:   
汪柏云, 陈晓运, 胡春仙, 吴秋楠. 35岁及以上产妇产后压力性尿失禁的影响因素分析[J]. 预防医学, 2022, 34(9): 959-963.
WANG Baiyun, CHEN Xiaoyun, HU Chunxian, WU Qiunan. Factors affecting postpartum stress urinary incontinence among lying-in women at ages of 35 years and older. Preventive Medicine, 2022, 34(9): 959-963.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2022.09.020      或      http://www.zjyfyxzz.com/CN/Y2022/V34/I9/959
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