Eftekhar T, Hajibaratali B, Ramezanzadeh F, Shariat M
Vali-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Int J Gynaecol Obstet. 2006 Aug;94(2):114-8. doi: 10.1016/j.ijgo.2006.04.042. Epub 2006 Jul 17.
To assess the prevalence of postpartum stress urinary incontinence (SUI); the relationship between postpartum SUI and mode of delivery; and the association between SUI and other obstetric factors.
In this prospective study, 1000 primiparas with no history of UI were recruited and followed up for 4 months after delivery. The chi(2) and Fisher's Exact tests were used to calculate the effects of the nominal variables.
The prevalence of postpartum SUI was 14.1%, and the mode of delivery was significantly associated with SUI. The prevalence rates were 15.9% after vaginal delivery, 10.7% after elective cesarean section (CS), and 25% after CS performed for obstructed labor. The prevalence of postpartum SUI was similar following spontaneous vaginal delivery and CS performed for obstructed labor (P=.21). Meanwhile, elective CS with no trial of labor was found to be associated with a significantly lower prevalence of postpartum SUI (P=.01; chi(2)=12.42). A maternal body mass index greater than 30 before pregnancy and fetal weight higher than 3000 g appeared to be associated with an increased rate of SUI (P=.001; chi(2)=17.6 and P=.000; chi(2)=22.5, respectively).
Elective CS significantly reduced the rate of postpartum SUI.
评估产后压力性尿失禁(SUI)的患病率;产后SUI与分娩方式之间的关系;以及SUI与其他产科因素之间的关联。
在这项前瞻性研究中,招募了1000名无尿失禁病史的初产妇,并在产后随访4个月。采用卡方检验和Fisher精确检验来计算名义变量的效应。
产后SUI的患病率为14.1%,分娩方式与SUI显著相关。阴道分娩后的患病率为15.9%,择期剖宫产(CS)后的患病率为10.7%,因难产而行CS后的患病率为25%。自然阴道分娩与因难产而行CS后产后SUI的患病率相似(P = 0.21)。同时,未进行试产的择期CS与产后SUI的患病率显著降低相关(P = 0.01;卡方 = 12.42)。孕前体重指数大于30以及胎儿体重高于3000 g似乎与SUI发生率增加相关(分别为P = 0.001;卡方 = 17.6和P = 0.000;卡方 = 22.5)。
择期CS显著降低了产后SUI的发生率。