高龄阴道分娩产妇产后发生盆底功能障碍的危险因素分析

Analysis of risk factors of postpartum pelvic floor dysfunction in elderly women with vaginal delivery

目的分析导致高龄阴道分娩产妇产后发生盆底功能障碍的危险因素。方法80例经阴道成功分娩胎儿的高龄产妇,根据是否发生产后盆底功能障碍分为观察组(产后盆底功能障碍)和对照组(无产后盆底功能障碍),每组40例。对两组一般资料进行回顾性分析,采用Logistic回归模型分析高龄阴道分娩产妇产后发生盆底功能障碍的独立危险因素。结果两组产妇第一产程持续时间>12 h占比、孕周比较差异无统计学意义(P>0.05);观察组产妇年龄≥40岁、妊娠期间体重增加量≥12 kg、妊娠期出现尿失禁、第二产程持续时间≥12 h、难产占比分别为57.50%、67.50%、35.00%、72.50%、62.50%均高于对照组的17.50%、15.00%、10.00%、12.50%、17.50%,差异具有统计学意义(P<0.05)。年龄≥40岁、妊娠期体重增加≥12 kg、妊娠期出现尿失禁、第二产程时间≥12 h、难产为导致高龄阴道分娩产妇产后发生盆底功能障碍的独立危险因素(P<0.05)。结论年龄≥40岁、妊娠期体重增加≥12 kg、妊娠期出现尿失禁、第二产程时间≥12 h、难产为导致高龄阴道分娩产妇产后发生盆底功能障碍的独立危险因素,因此应控制妊娠期间体重增加量,观察妊娠期是否出现尿失禁情况,缩短第二产程持续时间,避免出现难产情况,从而降低产妇产后发生盆底功能障碍的风险。

Objective To analyze the risk factors of postpartum pelvic floor dysfunction in elderly women with vaginal delivery.Methods A total of 80 elderly women with successful vaginal delivery were divided into observation group(with postpartum pelvic floor dysfunction)and control group(without postpartum pelvic floor dysfunction)according to whether postpartum pelvic floor dysfunction occurred,with 40 cases in each group.The general data of the two groups were retrospectively analyzed,and the Logistic regression model was used to analyze the independent risk factors of postpartum pelvic floor dysfunction in elderly vaginal delivery women.Results There was no statistically significant difference in the proportion of the first stage of labor>12 h and the gestational age between the two groups(P>0.05).In the observation group,the proportions of maternal age≥40 years old,weight gain during pregnancy≥12 kg,urinary incontinence during pregnancy,second stage of labor≥12 h,and dystocia were 57.50%,67.50%,35.00%,72.50%,and 62.50%,which were higher than 17.50%,15.00%,10.00%,12.50%,and 17.50%in the control group,and the differences were statistically significant(P<0.05).Age≥40 years old,weight gain≥12 kg during pregnancy,urinary incontinence during pregnancy,second stage of labor≥12 h,and dystocia were independent risk factors for postpartum pelvic floor dysfunction in elderly vaginal delivery women(P<0.05).Conclusion Age≥40 years old,weight gain≥12 kg during pregnancy,urinary incontinence during pregnancy,second stage of labor≥12 h,and dystocia are independent risk factors for postpartum pelvic floor dysfunction in elderly vaginal delivery women.Therefore,it is important to control the amount of weight gain during pregnancy,observe for urinary incontinence during pregnancy,and shorten the duration of the second stage of labor to avoid dystocia,thus reducing the risk of pelvic floor dysfunction after delivery.