McKinnie Vikki, Swift Steven E, Wang Wei, Woodman Patrick, O'Boyle Amy, Kahn Margie, Valley Michael, Bland Deirdre, Schaffer Joe
Division of Benign Gynecology, Department of Obstetrics & Gynecology, Medical University of South Carolina, Charleston 29425, USA.
Am J Obstet Gynecol. 2005 Aug;193(2):512-7; discussion 517-8. doi: 10.1016/j.ajog.2005.03.056.
The purpose of this study was to determine the relative effects of pregnancy and mode of delivery on the prevalence of urinary and fecal incontinence.
This was a prospective, observational multicenter study of women presenting to 6 gynecology clinics. Demographic data collected included: height, weight, gravidity, parity, and number of vaginal deliveries. Patients were diagnosed with incontinence by questionnaire. Standard univariate logistic regression analyses' were performed to determine the contribution of pregnancy, mode of delivery, and BMI on the prevalence of urinary and fecal incontinence.
One thousand and four women were enrolled over an 18-month period. Two hundred and thirty-seven and 128 subjects had urinary and fecal incontinence, respectively. Odds ratio (95% CI) calculated for the prevalence of urinary incontinence by pregnancy and mode of delivery were: any term pregnancy vs no term pregnancy was 2.46 (1.53-3.95), any term pregnancy but no vaginal deliveries (cesarean section only) vs no term pregnancy was 1.95 (0.99-3.80), any term pregnancy and at least 1 vaginal delivery vs no term pregnancy was 2.53 (1.57-4.07), and any term pregnancy but no vaginal delivery (cesarean section only) vs any term pregnancy, and at least 1 vaginal delivery was 1.30 (0.77-3.95). Odds ratio (95% CI) calculated for the prevalence of fecal incontinence by pregnancy and mode of delivery were: any term pregnancy vs no term pregnancy was 2.26 (1.22-4.19), any term pregnancy but no vaginal deliveries (cesarean section only) vs no term pregnancy was 1.13 (0.43-2.96), any term pregnancy and at least 1 vaginal delivery vs no term pregnancy was 2.41 (1.30-4.49), and any term pregnancy but no vaginal deliveries (cesarean section only) vs any term pregnancy, and at least 1 vaginal delivery was 2.15 (0.97-4.77). BMI and age did not impact these results.
Pregnancy increases the risk of urinary and fecal incontinence. Cesarean section does not decrease the risk of urinary or fecal incontinence compared to pregnancy with a vaginal delivery.
本研究旨在确定妊娠和分娩方式对尿失禁和粪失禁患病率的相对影响。
这是一项针对前往6家妇科诊所就诊女性的前瞻性观察性多中心研究。收集的人口统计学数据包括：身高、体重、妊娠次数、产次和阴道分娩次数。通过问卷调查对患者进行尿失禁诊断。进行标准单因素逻辑回归分析，以确定妊娠、分娩方式和体重指数对尿失禁和粪失禁患病率的影响。
在18个月期间共纳入1004名女性。分别有237名和128名受试者患有尿失禁和粪失禁。根据妊娠和分娩方式计算的尿失禁患病率的比值比（95%可信区间）为：任何足月妊娠与未足月妊娠相比为2.46（1.53 - 3.95），任何足月妊娠但无阴道分娩（仅剖宫产）与未足月妊娠相比为1.95（0.99 - 3.80），任何足月妊娠且至少有1次阴道分娩与未足月妊娠相比为2.53（1.57 - 4.07），任何足月妊娠但无阴道分娩（仅剖宫产）与任何足月妊娠且至少有1次阴道分娩相比为1.30（0.77 - 3.95）。根据妊娠和分娩方式计算的粪失禁患病率的比值比（95%可信区间）为：任何足月妊娠与未足月妊娠相比为2.26（1.22 - 4.19），任何足月妊娠但无阴道分娩（仅剖宫产）与未足月妊娠相比为1.13（0.43 - 2.96），任何足月妊娠且至少有1次阴道分娩与未足月妊娠相比为2.41（1.30 - 4.49），任何足月妊娠但无阴道分娩（仅剖宫产）与任何足月妊娠且至少有1次阴道分娩相比为2.15（0.97 - 4.77）。体重指数和年龄不影响这些结果。
妊娠会增加尿失禁和粪失禁的风险。与阴道分娩的妊娠相比，剖宫产并不会降低尿失禁或粪失禁的风险。
Zotero 插件