二胎产妇产后腹直肌分离症的发生状况及其影响因素分析

Analysis of the occurrence of postpartum diastasis recti abdominis in second-child parturients and its influencing factors

目的分析二胎产妇产后腹直肌分离症(DRA)的发生状况及其影响因素。方法前瞻性选择2020年1月至2021年6月在惠州中心人民医院建档、规律产前检查、住院分娩的产妇200例进行研究。所有产妇均分娩后6周、6个月、12个月进行腹直肌检测,观察DRA的发生状况,将单因素分析有统计学意义的变量进行多因素Logistic回归分析。结果200例患者均完成产后6周时的测量,其中DRA 102例,发生率为51.00%(102/200);产后6个月时,DRA 79例,发生率为39.50%(79/200);产后12个月时,DRA 54例,发生率为27.00%(54/200)。以产后12个月诊断为DRA的54例产妇为DRA组,146例无DRA产妇为无DRA组。DRA组产妇的年龄、孕期腹围、存在腹部手术史例数、生产方式为剖宫产例数、新生儿出生体质量、双胞胎例数均大(多)于无DRA组,差异均有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,年龄较大、孕期腹围增加较高、新生儿出生质量较大、双胞胎、两次均为剖宫产以及存在腹部手术史是导致DRA发生的危险因素(P<0.05)。结论二胎产妇DRA的发生率较高,其中产妇年龄较大、孕期腹围增加较大、多胎、新生儿出生体质量较大以及剖宫产、腹部手术史是导致DRA发生的高危因素。

Objective To analyze the occurrence of postpartum diastasis recti abdominis(DRA)in second-child parturients and its influencing factors.Methods A total of 200 pregnant women who filed,regularly examined,and delivered in Huizhou Central People's Hospital from Jan.2020 to Jun.2021 were prospectively selected.All women underwent rectus abdominis testing at 6 weeks,6 months,and 12 months after childbirth,and the occurrence of DRA were observed.Multivariate logistic regression analysis was performed on statistically significant variables for univariate analysis.Results All patients completed the measurement at 6 weeks postpartum,including 102 cases of DRA,with an incidence rate of 51.00%(102/200).At 6 months after delivery,there were 79 cases of DRA,with an incidence of 39.50%(79/200).At 12 months postpartum,there were 54 cases of DRA,with an incidence rate of 27.00%(54/200).The 54 parturients diagnosed with DRA at 12 months postpartum were included in the DRA group,and 146 parturients without DRA were regarded as the DRA-free group.The maternal age,abdominal circumference during pregnancy,the number of women with history of abdominal surgery,the number of women undergoing cesarean sections,body mass of the newborns,and the number of twins were greater(more)in the DRA group than the DRA-free group(P<0.05).Multivariate Logistic regression analysis showed that older maternal age,greater increase in abdominal circumference during pregnancy,larger body mass of newborns,twins,both cesarean sections,and a history of abdominal surgery were risk factors for DRA(P<0.05).Conclusion The incidence of DRA in second-child parturients is relatively high,and older maternal age,greater increase in abdominal circumference during pregnancy,multiple births,larger body mass of newborns,and history of cesarean section and abdominal surgery are the high-risk factors for DRA.