孕期瑜伽训练对孕产妇盆底肌力的影响

Effect of yoga training during pregnancy on pelvic floor muscle strength in pregnant women

目的探讨孕期瑜伽训练对孕产妇盆底肌力、尿失禁及分娩情况的影响。方法前瞻性纳入2016年1月—12月正常健康妊娠女性200例,随机分为瑜伽组和对照组,各100例。对照组给予常规产前检查和围产期健康教育,瑜伽组在对照组基础上,自孕16 w至孕37 w在专业人员指导下进行瑜伽训练。对比两组盆底肌力变化、孕期和产后尿失禁发生率、自然分娩率、自然分娩各产程时间。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果瑜伽组孕24 w、36 w、产后6 w盆底肌力[深部(3.6±1.5)、(3.2±1.4)、(2.8±1.2)分;浅部(3.5±1.4)、(3.1±1.5)、(2.6±1.3)分]优于对照组[深部(3.2±1.3)、(2.8±1.2)、(2.4±1.0)分;浅部(3.1±1.2)、(2.7±1.3)、(2.1±1.1)分](均P<0.05);瑜伽组孕24 w、36 w和产后6 w尿失禁发生率(14%、19%、13.2%)低于对照组(26%、33%、27.4%)(均P<0.05);瑜伽组自然分娩率76%高于对照组62%(P<0.05);瑜伽组自然分娩第二产程[(42.5±18.2)min]短于对照组[(53.8±25.7)min](P<0.05)。结论孕期瑜伽训练有助于改善盆底肌力,减少孕期和产后尿失禁的发生率、提高自然分娩率、缩短第二产程时间。

Objective To investigate the effect of yoga training during pregnancy on pelvic floor muscle strength, urinary incontinence and delivery process. Methods A total of 200 cases of healthy pregnant women colleeted from January 2016 to December were randomly divided into the yoga group and the control group（n=100）. Control group received routine prenatal examination and perinatal health education, while yoga group carried out yoga training under the guidance of professional staff from 16 weeks to 37 weeks of pregnancy on the basis of control group. Pelvic floor muscle strength, the incidence of urinary incontinence during pregnancy and postpartum, the proportion of natural labor and the time of delivery process were recorded. Measurement data uses t test, and count data uses χ^2 test. P〈0.05 is considered statistically significant. Results The pelvic floor muscle strength in the yoga group at 24 weeks, 36 weeks of pregnancy and 6 weeks postpartum [deep：（3.6±1.5）,（3.2±1.4）,（2.8±1.2） score, shallow：（3.5±1.4）,（3.1±1.5）,（2.6±1.3） score], were better than the control group[deep：（3.2±1.3）,（2.8±1.2）,（2.4±1.0） score,shallow：（3.1±1.2）,（2.7±1.3）,（2.1±1.1） score]（all P〈0.05）. The occurrence rate of urinary incontinence in the yoga group at 24, 36 weeks of pregnancy and 6 weeks postpartum（14%, 19%, and 13.2%） were lower than the control group（26%, 33%, and 27.4%）（all P〈0.05）.The natural delivery rate in the yoga group（76%） was higher than the control group（62%）（P〈0.05）. The second stage of labor time of natural childbirth puerpera in the yoga group[（42.5 ±18.2） min] was shorter than the control group[（53.8 ± 25.7） min]（P〈0.05）. Conclusion Yoga training during pregnancy is helpful to improve pelvic floor muscle strength,reduce urinary incontinence incidence during pregnancy and postpartum, improve the natural delivery rate, and shorten the second stage of labor.