Department of Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil.
Clinics (Sao Paulo). 2011;66(8):1341-6. doi: 10.1590/s1807-59322011000800006.
To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery.
Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes and 98 women without the disease were screened for incontinence and vaginal pressure. Multiple logistic regression models were used to evaluate the independent effects of gestational diabetes.
The prevalence of gestational incontinence was higher among women with gestational diabetes during their pregnancies (50.8% vs. 31.6%) and two years after a cesarean (44.8% vs. 18.4%). Decreased vaginal pressure was also significantly higher among women with gestational diabetes (53.9% vs. 37.8%). Maternal weight gain and newborn weight were risk factors for decreased vaginal pressure. Maternal age, gestational incontinence and decreased vaginal pressure were risk factors for incontinence two years after a cesarean. In a multivariate logistic model, gestational diabetes was an independent risk factor for gestational incontinence.
The prevalence of incontinence and decreased vaginal pressure two years post-cesarean were elevated among women with gestational diabetes compared to women who were normoglycemic during pregnancy. We confirmed an association between gestational diabetes mellitus and a subsequent decrease of vaginal pressure two years post-cesarean. These results may warrant more comprehensive prospective and translational studies.
评估初产妇在剖宫产两年后有无既往妊娠糖尿病（GDM）时的尿失禁发生率及相关阴道收缩压。
对两年前行剖宫产分娩的初产妇进行了有关分娩和失禁发生情况的访谈。通过女性自述报告失禁情况，使用 Perina 会阴压力计评估阴道压力。对 63 例患有 GDM 的妇女和 98 例无该疾病的妇女进行了失禁和阴道压力筛查。采用多因素逻辑回归模型评估 GDM 的独立影响。
妊娠期间患有 GDM 的女性（50.8% vs. 31.6%）和剖宫产两年后（44.8% vs. 18.4%）发生妊娠性尿失禁的比例较高。患有 GDM 的女性阴道压力明显下降的比例也较高（53.9% vs. 37.8%）。产妇体重增加和新生儿体重是阴道压力降低的危险因素。产妇年龄、妊娠性尿失禁和阴道压力降低是剖宫产两年后尿失禁的危险因素。在多因素逻辑回归模型中，GDM 是妊娠性尿失禁的独立危险因素。
与妊娠期间血糖正常的女性相比，患有 GDM 的女性在剖宫产两年后发生尿失禁和阴道压力降低的比例较高。我们证实了妊娠糖尿病与剖宫产两年后阴道压力下降之间存在关联。这些结果可能需要更全面的前瞻性和转化性研究。
