Hijaz Adonis, Sadeghi Zhina, Byrne Lauren, Hou Jack Cheng-Tsung, Daneshgari Firouz
Department of Urology, Case Western Reserve University, University Hospitals of Case Medical Center, Cleveland, OH 44106, USA.
Int Urogynecol J. 2012 Apr;23(4):395-401. doi: 10.1007/s00192-011-1562-5. Epub 2011 Sep 8.
The pathophysiology of stress urinary incontinence (SUI) is multifactorial and evidence supports a critical role of pregnancy and vaginal delivery. This review dissects epidemiologic literature to determine the weight of evidence on the role of advanced maternal age (AMA) as a risk factor for the development of subsequent or persistent SUI. We conducted a Medline search using the keywords postpartum, SUI, maternal age, pregnancy, and incontinence. The published literature was critically analyzed. Evidence supports that childbirth trauma contributes to the development and severity of SUI. Yet, there is contradicting evidence as to whether AMA increases the risk. AMA clearly represents an independent risk factor for postpartum SUI. However, long-term studies did not confirm this observation. Whether this finding is suggestive of a true biologic signal that is lost with competing risk factors over time warrants further research.
压力性尿失禁（SUI）的病理生理学是多因素的，有证据支持妊娠和阴道分娩起关键作用。本综述剖析流行病学文献，以确定高龄产妇（AMA）作为后续或持续性SUI发生风险因素的证据权重。我们使用产后、SUI、产妇年龄、妊娠和失禁等关键词在Medline上进行了检索。对已发表的文献进行了严格分析。有证据支持分娩创伤会导致SUI的发生和严重程度。然而，关于AMA是否会增加风险存在相互矛盾的证据。AMA显然是产后SUI的一个独立风险因素。然而，长期研究并未证实这一观察结果。随着时间的推移，这种发现是否暗示了一种真正的生物学信号因竞争风险因素而消失，值得进一步研究。
