超重和肥胖妇女孕期体质量管理及主要危险因素对产后盆底功能的影响

Effects of body weight management during pregnancy and the main risk factors on postpartum pelvic floor function in overweight and obese women

目的探讨超重和肥胖妇女在孕期体质量管理及其主要危险因素对产后盆底功能障碍性疾病(FPFD)的影响。方法选取2019年1—12月于广州市天河区妇幼保健院定档产检产妇914例作为研究对象,孕期以指导饮食和运动为体质量管理干预方案,记录整个孕期体质指数(BMI)、孕期增加体质量等指标,在产后6周复查时进行盆底肌功能检测,分析影响FPFD的相关因素,进一步采用多因素logistic回归分析超重和肥胖与FPFD的关联性,探讨体质量管理对产后盆底功能的影响。结果分析结果显示,分娩方式、孕前BMI及孕期增加体质量是发生FPFD有关因素(P<0.05);多因素logistic回归分析结果显示,孕前BMI及孕期增加体质量是发生FPFD的独立危险因素,超重、肥胖、孕期增加体质量9~16 kg和孕期增加体质量≥16 kg均与产后FPFD发生有关,差异有统计学意义(P<0.05)。结论超重和肥胖与FPFD的发生密切相关,进行孕期体质量管理有利于产后盆底功能恢复。

Objective To explore the effects of body weight management during pregnancy and the main risk factors on postpartum pelvic floor dysfunction(FPFD)in overweight and obese women.Methods From January to December in 2019,914 women receiving prenatal examination in Maternal and Child Health Care Hospital of Tianhe District,Guangzhou were selected as study object,body weight management and intervention program during pregnancy was given,including dietary guidance and exercise guidance,the indexes were recorded,including body mass index(BMI)during pregnancy and body weight gain during pregnancy,pelvic floor muscle function examination was performed at 6 weeks after delivery,the related factors of FPFD were analyzed,the correlations between overweight,obesity and FPFD were analyzed by multivariate logistic regression analysis,the effect of body weight management during pregnancy on postpartum pelvic floor function was analyzed.Results Delivery mode,BMI before pregnancy,and body weight management during pregnancy were related factors of FPFD(P<0.05).Multivariate logistic regression analysis showed that BMI before pregnancy and body weight management during pregnancy were independent risk factors of FPFD,overweight,obesity,body weight management during pregnancy(9-16 kg),and body weight management during pregnancy(≥16 kg)were correlated with occurrence of FPFD,there were statistically significant differences(P<0.05).Conclusion Overweight and obesity are closely correlated with occurrence of FPFD,body weight management during pregnancy is beneficial to recovery of pelvic floor function.