高龄产妇产后早期盆底肌力受损的多因素分析

Influencing factors analysis of pelvic floor muscle strength in the early postpartum period of elderly pregnant women

目的探讨高龄产妇产后早期盆底肌力受损的相关影响因素。方法选取产后6~8周行盆底筛查的高龄(年龄≥35周岁)产妇350例,通过问卷调查及盆底肌力检测了解其病历资料、盆底功能状况,采用logistic回归分析高龄产妇产后盆底肌力受损的相关影响因素。结果共获得有效问卷335份,问卷有效回收率为95.71%,335例高龄产妇早期盆底肌力受损发生率为65.37%(219/335)。多因素分析结果显示:孕期体重增加≥20 kg、第二产程≥2 h、阴道分娩、新生儿体重≥4.0 kg、分娩次数≥2次是高龄产妇产后盆底肌力受损的危险因素(OR分别=2.18、2.30、1.98、5.09、3.21、P均<0.05),行盆底功能锻炼和从事轻度的体力劳动是高龄产妇产后盆底肌力受损的保护因素(OR分别=0.44、0.47,P均<0.05)。结论高龄产妇产后盆底肌力受损的发生风险较高,应加强孕妇孕期体重管理和围产期盆底知识宣教,指导临近预产期开展盆底功能训练,以预防和减少产后盆底功能障碍性疾病的发生。

Objective To explore the related factors of the injury of pelvic floor muscle strength in the early postpartum period in the elderly women.Methods Totally 350 women older than 35 years old who underwent pelvic floor screening in 6~8 weeks postpartum were selected.The clinical data and pelvic floor function were obtained.Logistic regression analysis were used to analyze the related factors of the impairment of pelvic floor muscle strength.Results Totally 335 effective questionnaires were obtained,the effective rate was 95.71%,and the incidence of early pelvic floor muscle strength damage was 65.37%(219/335).The results of multivariate analysis showed that weight gain during pregnancy heavier than 20 kg,second stage of labor longer than 2 h,vaginal delivery,newborn weight≥4.0 kg,the delivery more than 2 times were the risk factors of postpartum pelvic floor muscle damage(OR=2.18,2.30,1.98,5.09,3.21,P<0.05).Taking pelvic floor functional exercise and light physical labor were the protective factors of postpartum pelvic floor muscle damage(OR=0.44,0.47,P<0.05).Conclusion In order to prevent and reduce the occurrence of postpartum pelvic floor dysfunction diseases,we should strengthen the weight management during pregnancy and the education of perinatal pelvic floor knowledge,and take pelvic floor functional exercise.