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单次经阴道分娩对压力性尿失禁患病率的影响:一项前瞻性队列研究。

Effect of one interval vaginal delivery on the prevalence of stress urinary incontinence: a prospective cohort study.

作者信息

Yip Shing-Kai, Sahota Daljit, Chang Allan, Chung Tony

机构信息

Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong.

出版信息

Neurourol Urodyn. 2003;22(6):558-62. doi: 10.1002/nau.10113.

Abstract

AIMS

To analyze the effect of one interval vaginal delivery on the prevalence of stress urinary incontinence amongst a cohort of nulliparous women.

METHODS

A cohort of 276 nulliparous women without incontinence was recruited consecutively in 1996, after they had vaginal delivery, and were followed-up for urinary incontinence in 2000. The age, obstetric variables of the 1996 delivery (mode of delivery, genital tract trauma, birth weight, epidural analgesia, episiotomy, durations of labor, postpartum urinary retention), and the presence of interval vaginal delivery during the follow-up period were recorded. The obstetric factors and the prevalence of urinary stress incontinence at follow-up were then compared between women with and without interval vaginal delivery. Logistic regression analysis was performed to test the independence of the obstetric variables in the index pregnancy and the presence of one interval vaginal delivery, with urinary stress incontinence being the dependent variable.

RESULTS

A total of 148 (53.6%) women were followed-up. The prevalence of urinary incontinence was 28.6% in women without interval delivery and 21.1% in women with one interval delivery. There was no significant difference in the prevalence of urinary incontinence between the two groups (chi(2) test, P = 0.31). Logistic regression showed that none of the obstetric variables or the presence of one interval vaginal delivery was significantly associated with urinary incontinence.

CONCLUSIONS

One interval vaginal delivery does not increase risk of urinary stress incontinence 4 years after the index vaginal delivery.

摘要

目的

分析首次经阴道分娩对一群未生育过的女性压力性尿失禁患病率的影响。

方法

1996年连续招募了276名无尿失禁的未生育女性,她们经阴道分娩后,于2000年对其尿失禁情况进行随访。记录了她们的年龄、1996年分娩时的产科变量(分娩方式、生殖道创伤、出生体重、硬膜外镇痛、会阴切开术、产程、产后尿潴留)以及随访期间是否有再次经阴道分娩。然后比较有和没有再次经阴道分娩的女性的产科因素及随访时压力性尿失禁的患病率。进行逻辑回归分析,以尿失禁为因变量,检验首次妊娠时产科变量及有一次再次经阴道分娩情况的独立性。

结果

共有148名(53.6%)女性接受了随访。未再次经阴道分娩的女性尿失禁患病率为28.6%,有一次再次经阴道分娩的女性患病率为21.1%。两组间尿失禁患病率无显著差异(卡方检验,P = 0.31)。逻辑回归显示,产科变量及有一次再次经阴道分娩情况均与尿失禁无显著相关性。

结论

首次经阴道分娩后4年,一次再次经阴道分娩不会增加压力性尿失禁的风险。

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