Rortveit Guri, Daltveit Anne Kjersti, Hannestad Yngvild S, Hunskaar Steinar
Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Ulriksdal 8c, N-5009 Bergen, Norway.
Am J Obstet Gynecol. 2003 Nov;189(5):1268-74. doi: 10.1067/s0002-9378(03)00588-x.
The study was undertaken to investigate the effect of nine delivery parameters on urinary incontinence in later life.
Incontinence data from the EPINCONT study were linked to the Medical Birth Registry of Norway. Effects of birth weight, gestational age, head circumference, breech delivery, injuries in the delivery channel, functional delivery disorders, forceps delivery, vacuum delivery, and epidural anesthesia were investigated. The study covered women younger than 65 years, who had had vaginal deliveries only (n=11,397).
Statistically significant associations were observed between any incontinence and birth weight 4000 g or greater (odds ratio [OR] 1.1, 95% CI 1.0-1.2); moderate or severe incontinence and functional delivery disorders (OR 1.3, 95% CI 1.1-1.6); stress incontinence and high birth weight (OR 1.2, 95% CI 1.1-1.3) and epidural anesthesia (OR 1.2, 95% CI 1.0-1.5); and urge incontinence and head circumference 38 cm or larger (OR 1.8, 95% CI 1.0-3.3).
The effects were too weak to explain a substantial part of the association between vaginal delivery and urinary incontinence, and statistically significant results may have incurred by chance.
本研究旨在调查九个分娩参数对晚年尿失禁的影响。
将EPINCONT研究中的失禁数据与挪威医疗出生登记处的数据相联系。研究了出生体重、孕周、头围、臀位分娩、产道损伤、功能性分娩障碍、产钳助产、真空助产和硬膜外麻醉的影响。该研究涵盖了年龄小于65岁、仅经阴道分娩的女性(n = 11397)。
观察到任何类型的失禁与出生体重4000克或更高之间存在统计学显著关联(比值比[OR]1.1,95%置信区间1.0 - 1.2);中度或重度失禁与功能性分娩障碍之间存在关联(OR 1.3,95%置信区间1.1 - 1.6);压力性失禁与高出生体重(OR 1.2,95%置信区间1.1 - 1.3)和硬膜外麻醉(OR 1.2,95%置信区间1.0 - 1.5)之间存在关联;急迫性失禁与头围38厘米或更大之间存在关联(OR 1.8,95%置信区间1.0 - 3.3)。
这些影响过于微弱,无法解释阴道分娩与尿失禁之间关联的很大一部分,具有统计学显著意义的结果可能是偶然产生的。