社区育龄期女性膀胱过度活动症危险性与分娩相关性的前瞻性研究

Prospective study of risk of overactive bladder symptoms and delivery in women of reproductive age

目的：验证绝经前期女性存在膀胱过度活动症（OAB）及其与分娩资料的相关性。方法本研究采用国际尿失禁咨询委员会问卷（ICIQ）-OAB 问卷（国际尿控协会标准）中文版本和人口数据问卷调查深圳市龙岗区某社区2104名，20～45岁女性OAB症状。结果 ICIQ-OAB问卷得分由高到低依次为经产妇、初产妇和未产妇。其中经产妇尿频发生率也比未产妇高（P＜0.0001）。未产妇夜尿症发生率比初产妇和经产妇低（P＜0.0001）。各组间急迫性尿失禁的发生率无统计学差异（P＝0.0682），但经产妇急迫性尿失禁发生率较未产妇高（P＝0.0313）。虽然剖宫产和经阴道分娩妇女ICIQ-OAB问卷得分无明显差异，但是阴道分娩妇女得分较剖宫产妇女高。结论随着分娩次数的增加即由未产妇、初产妇到经产妇，出现OAB症状的危险性增加。与未产妇相比，无论哪种分娩方式均与ICIQ-OAB问卷得分高（更严重的症状）相关。

Objective To verify the presence of overactive bladder （OAB） symptoms in premenopausal women and relate them with child-bearing data. Methods We interviewed 2104 women aged 20-45 years in the district of Longgang to investigate the prevalence of OAB symptoms. In this study we used the International Consultation on Incontinence Questionnaire-Overactive Bladder （ICIQ-OAB） questionnaire （International Continence Society standard）, in its validated chinese version and a specific questionnaire for the demographics. Results Overall, ICIQ-OAB questionnaire scores in descending order by multiparous, primiparous and nulliparous women. Multiparous women also presented more frequency than nulliparous women （P〈0.000 1）. Nulliparous women presented less nocturia than primiparous or multiparous women （P〈0.000 1）. No significant differences were found in urgency （P=0.068 2）, and multiparous women presented more urgency incontinence than nulliparous ones （P=0.031 3）. There were no significant differences between cesarean and vaginal delivery, but the scores of women who had vaginal delivery were higher than those who had cesareans. Conclusion From multiparous, primiparous to nulliparous women, with the increase in the number of deliveries the risk of OAB symptoms increase. Both types of delivery were related to higher ICIQ-OAB scores （more severe symptoms） than those of nulliparous women.