中国育龄期妇女产后腹直肌分离发生率meta分析

Incidence of postpartum diatasis recti abdominis in Chinese childbearing women-a meta analysis

目的使用meta分析定量综合分析中国育龄期妇女产后腹直肌分离的发生率,为产前保健、产后康复和产后护理临床决策及相关政策的制定提供一定参考依据。方法由2名研究人员独立系统检索Embase、Pubmed、Web of science、CBM、CNKI、万方数据库,收集关于中国育龄期妇女产后腹直肌分离发生率的横断面研究,并由双人独立筛选文献、提取相关数据和评价相关研究质量后,采用STATA14.0统计软件对数据进行定量合并。结果最终5篇文献符合纳入排除标准被纳入研究,包括12857名研究对象。meta分析结果显示:中国育龄期妇女产后腹直肌分离的发生率为45.14%(95%CI=29.72%~59.62%);亚组分析结果显示,经产妇腹直肌分离发生率高于初产妇(67.20%VS 48.63%);剖腹产产妇腹直肌分离发生率高于顺产(51.78%VS 39.72%),且差异具有统计学意义(P<0.001)。结论中国育龄期妇女产后腹直肌分离发生率较高,经产、剖腹产是高危因素,在产前保健、产后康复和产后护理及将来公共卫生政策制定过程中应引起足够的关注。

Objective To evaluate the incidence of postpartum diatasis recti abdominis in Chinese childbearing women with meta analysis and to provide references for making clinical decision and policies on prenatal care,postpartum care and postpartum rehabilitation.Methods We searched Embase,Pubmed,Web of science,China Biology Medicine(CBM),China National Knowledge Infrastructure(CNKI),and WanFang Database to collect cross-sectional studies on incidence of postpartum diatasis recti abdominis in Chinese childbearing women up to March 30,2020.Two reviewers screened literatures retrieved,extracted relevant data,and evaluated the quality of the studies independently.STATA14.0 was used to merge and analyze the data quantitatively.Results Among 12857 participants of 5 studies included in the analysis,the incidence of postpartum diatasis recti abdominis was 45.14%(95%confidence interval:29.72%–59.62%).Subgroup analysis demonstrated that the incidence of postpartum diatasis recti abdominis was significantly higher among multiparas than among primiparas(53.78%vs.12.50%,P<0.001)and higher among puerperae undergoing cesarean section than among those with natural labour(51.78%vs.39.72%,P<0.001).Conclusion The incidence of diatasis recti abdominis is relatively high and multiparity and cesarean section are main risk factors for the incidence among Chinese childbearing women.The results need to be concerned in prenatal and postpartum care and postpartum rehabilitation in the women.