基于全孕周期数据的产后压力性尿失禁危险因素分析

Analysis of risk factors for postpartum stress urinary incontinence based on full pregnancy cycle data

目的了解产妇产后压力性尿失禁(SUI)的发病率,探索导致产后SUI发生的危险因素。方法纳入2021年1月至2021年12月在杭州市妇产科医院产检、分娩、并于产后6~8周回院随访的1627名产妇作为研究对象,根据其有无SUI分为SUI组(n=276)和正常组(n=1351),采用调查问卷收集产妇一般临床资料、压力性尿失禁相关情况,分析导致产后SUI发病的危险因素。结果产后SUI的发病率为16.9%,单因素分析发现产妇年龄、基础体重、基础BMI、新生儿出生体重、孕中期体重、孕中期BMI、孕中期腹围、孕中期高密度脂蛋白胆固醇水平、分娩方式与产后SUI相关(t/χ^(2)值为3.000、2.974、2.894、2.143、2.883、3.096、2.905、3.096和11.399,P<0.05)。多因素分析发现孕中期腹围(OR=1.027,95%CI:1.005~1.051)、分娩年龄(OR=1.050,95%CI:1.008~1.091)、孕中期高密度脂蛋白胆固醇(OR=0.660,95%CI:0.450~0.971)与产后SUI相关,其中孕中期腹围及分娩年龄为产后SUI发病的危险因素。结论产妇分娩年龄、孕中期腹围是产后SUI的危险因素,孕中期高密度脂蛋白是产后SUI的保护因素。适龄妊娠分娩、定期进行盆底肌肉训练、控制孕期体重增加等可以降低SUI的发生率。

Objective To understand the incidence of postpartum stress urinary incontinence(SUI)among postpartum women and identify the risk factors for postpartum SUI.Methods A total of 1,627 postpartum women who underwent prenatal care,delivery,and follow-up visits at 6-8 weeks postpartum at Hangzhou maternity hospital from January 2021 to December 2021 were selected as the study subjects.They were divided into two groups based on the presence or absence of SUI:the SUI group(n=276)and the normal group(n=1351).A questionnaire was used to collect general clinical data and information related to stress urinary incontinence.Risk factors for postpartum SUI were analyzed.Results The incidence of postpartum SUI was 16.9%.Univariate analysis revealed that maternal age,baseline weight,baseline BMI,neonatal birth weight,second trimester weight,second trimester BMI,second trimester abdominal circumference,second trimester HDL cholesterol levels,and mode of delivery were associated with postpartum SUI(t/χ^(2) values were 3.000,2.974,2.894,2.143,2.883,3.096,2.905,3.096 and 11.399,respectively,all P<0.05).Multivariate analysis showed that second trimester abdominal circumference(OR=1.027,95%CI:1.005-1.051),delivery age(OR=1.050,95%CI:1.008-1.091),and second trimester HDL cholesterol(OR=0.660,95%CI:0.450-0.971)were associated with postpartum SUI.Among them,second trimester abdominal circumference and delivery age were identified as risk factors for the development of postpartum SUI.Conclusion Maternal delivery age and second trimester abdominal circumference are risk factors for postpartum SUI,while second trimester HDL cholesterol is a protective factor.Appropriate age for pregnancy and delivery,regular pelvic floor muscle training,and controlling weight gain during pregnancy can help reduce the incidence of SUI.