孕期体育锻炼对产后6~8周妇女盆底肌力的影响

Influence of the physical exercise during pregnancy of women on their pelvic floor muscle strength in postpartum 6-8 weeks

目的:调查产后妇女孕期体育锻炼情况,探讨其对产后盆底肌力的影响。方法:选取2021年8月-2022年3月在上海交通大学医学院附属同仁医院行产后6~8周检查且分娩单胎的妇女为研究对象,开展问卷调查和盆底肌力检测。调查人口学特征、孕期体育锻炼情况,检测阴道动态压力和盆底肌力,并综合评估盆底肌力是否正常,通过多因素logistic回归方法分析孕期体育锻炼对产后盆底肌力等的影响。结果:收集有效问卷873例,43.2%的产妇孕期进行体育锻炼,其中参加Kegel运动占22.3%,瑜伽占14.8%,孕妇保健操占12.0%,WAFF运动占11.9%。多因素logistic回归分析结果显示孕妇保健操和Kegel运动能显著增加盆底肌力整体正常比例,包括阴道动态压力和I、II类肌纤维肌力正常比例(OR=2.37,95%CI 1.15~4.91和OR=2.35,95%CI 1.22~4.53);孕期WAFF运动能增加产妇盆底I、II类肌纤维肌力正常比例(OR=1.83,95%CI 1.13~2.95和OR=2.28,95%CI 1.38~3.78)。随着孕期体育锻炼种类的增加,产后盆底I类肌肌力正常比例增加(OR=1.16,95%CI 1.00~1.33);阴道动态压力值正常比例增加(OR=1.49,95%CI 1.24~1.80);盆底肌力整体情况正常比例增加(OR=1.54,95%CI 1.22~1.96)。结论:孕妇保健操和Kegel运动显著提高产后盆底肌力整体情况;孕期WAFF运动能显著提高盆底肌力;孕期体育锻炼种类增加对改善阴道动态压力和盆底肌力有效。因此,经产科医生评估后,可在孕妇中推广上述3种运动,并提倡开展两种及以上的运动。

Objective:To investigate the physical exercise situation of women during pregnancy,and to study the influ-ence of the physical exercise of the women on their postpartum pelvic floor muscle strength.Methods:From August 2021 to March 2022.the women who came to Tongren Hospital afiliated to Shanghai JiaoTong University School of Medicine for 6-8 wecks postpartum examination and gave birth to a single child were selected as the participants.The questionnaire survey and the pelvic floor muscle strength test of the women were carried out.The general demographic characteristics and the physical exercise situation during pregnancy of the women were surveyed.The vaginal dynamic pressure and the pelvic floor muscle strength of the women were detected,and the pelvic floor muscle strength normal or not were evaluated comprehensively.Multivariate logistic regression was used to analyze the influence of the physical exercise during pregnancy of the women on their pelvic floor muscle strength.Results:A total of 873 valid question-naires were collected in this study.There were 43.2%women had taken part in physical exercise,including Kegel exer-cise of 22.3%,yoga of 14.8%,pregnant gymnastics of 12.0%,and WAFF exercise of 11.9%.The results of multiva-riate logistic regression analysis showed that the pregnant gymnastics and Kegel exercise of the women could signifi-cantly improve the proportions of their normal postpartum overall condition of pelvic floor muscle strength,including dynamie vaginal pressure,and class I and II muscle fiber strength(OR-2.37,95%CI 1.15-4.91,andOR-2.35,95%CI 1.22-4.53).WAFF exercise during pregnancy of the women could significantly improve the proportions of their normal postpartum pelvic floor muscle fibers of type I and II(OR=1.83,95%CI 1.13-2.95,and OR-2.28,95%CI 1.38-3.78).Along with the types of physical exercises of the women during pregnancy increased,the proportion of their normal postpartum pelvic floor muscle fibers of type I had increased(OR-1.16,95%CI 1.00-1.33).the proportion of their normal postpartum vaginal dynamie pressure had increased(OR-1.49,95%CI 1.24-1.80).and the proportion of their normal postpartum overall condition of pelvic floor muscle strength had also increased(OR-1.54,95%CI 1.22-1.96).Conclusion:The pregnant gymnastics and Kegel exercise of the women during pregnancy can significantly im-prove their postpartum overall condition of pelvic floor muscle strength.WAFF exercise of the women during pregnan-cy can significantly improve their postpartum pelvic floor muscle strength.The increase of the number of the physical exercises types of the women during pregnancy can effectively improve their postpartum dynamic vaginal pressure and pelvic floor muscle strength.Therefore,the pregnant gymnastics,Kegel exercise and WAFF exercise should be pro-moted among the pregnant women after the obstetrician evaluation.and two or more exercises of them should be advo-cated.