急迫性尿失禁：利用同卵双胞胎研究评估环境和产科风险因素
Urge incontinence: estimating environmental and obstetrical risk factors using an identical twin study.
作者信息
Gamble Tondalaya L, Du Hongyan, Sand Peter K, Botros Sylvia M, Rurak Magdalena, Goldberg Roger P
机构信息
NorthShore University HealthSystem, Division of Urogynecology, Department of Obstetrics and Gynecology, University of Chicago, Pritzker School of Medicine, Evanston, IL 60201, USA.
出版信息
Int Urogynecol J. 2010 Aug;21(8):939-46. doi: 10.1007/s00192-010-1140-2. Epub 2010 May 6.
INTRODUCTION AND HYPOTHESIS
The objective of this study was to determine risk factors for urge urinary incontinence (UUI).
METHODS
A multi-item survey was administered to a community sample of identical twin sisters from 2002-2008. Generalized estimating equations accounting for co-twin correlation were used to perform three different regression models on the outcome: UUI (yes vs. no).
RESULTS
Mean age, median parity, and BMI were 41.4 +/- 16.4 (18-85), 1.0, and 26.0 +/- 6.5 (13.5-55.8), respectively. Thirty-five percent of women were post-menopausal, and 27.5% had UUI. Urge urinary incontinence was reported in 40.1% of parous versus 14.1% among nulliparous women (p < .0001). The rate of UUI was 40.6% after vaginal delivery, 36.7% after cesarean delivery, and 14.1% in nulliparous women (p < .0001). Obesity, age >40, and chronic constipation were also identified as risk factors for urge urinary incontinence.
CONCLUSION
Risk factors for UUI include parity, age, obesity, and chronic constipation. There was a 2.5-fold increased risk of UUI after one or more births, regardless of type of delivery.
引言与假设
本研究的目的是确定急迫性尿失禁（UUI）的危险因素。
方法
在2002年至2008年期间，对同卵双胞胎姐妹的社区样本进行了多项调查。使用考虑双胞胎相关性的广义估计方程对结果进行三种不同的回归模型分析：UUI（是与否）。
结果
平均年龄、中位产次和体重指数分别为41.4±16.4（18 - 85岁）、1.0和26.0±6.5（13.5 - 55.8）。35%的女性已绝经，27.5%患有UUI。经产妇中报告有急迫性尿失禁的比例为40.1%，而未生育女性中这一比例为14.1%（p <.0001）。阴道分娩后UUI发生率为40.6%，剖宫产术后为36.7%，未生育女性为14.1%（p <.0001）。肥胖、年龄>40岁和慢性便秘也被确定为急迫性尿失禁的危险因素。
结论
UUI的危险因素包括产次、年龄、肥胖和慢性便秘。无论分娩方式如何，一次或多次分娩后UUI的风险增加2.5倍。
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