盆底肌肉力量可预测初产妇阴道分娩后压力性尿失禁的发生。
Pelvic floor muscle strength predicts stress urinary incontinence in primiparous women after vaginal delivery.
作者信息
Baracho Sabrina Mattos, Barbosa da Silva Lucas, Baracho Elza, Lopes da Silva Filho Agnaldo, Sampaio Rosana Ferreira, Mello de Figueiredo Elyonara
机构信息
Movement and Rehabilitation Sciences Program, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
出版信息
Int Urogynecol J. 2012 Jul;23(7):899-906. doi: 10.1007/s00192-012-1681-7. Epub 2012 Mar 1.
INTRODUCTION AND HYPOTHESIS
This study aimed to investigate obstetrical, neonatal, and clinical predictors of stress urinary incontinence (SUI) focusing on pelvic floor muscle (PFM) strength after vaginal delivery.
METHODS
A cross-sectional study was used, and potential predictors of SUI were collected 5-7 months postpartum on 192 primiparous women. Predictors that reached significance in the bivariate analysis were entered into the Classification and Regression Tree that identified interactions among them and cutoff points to orient clinical practice.
RESULTS
PFM strength was the strongest predictor of SUI. A combination of PFM strength ≤ 35.5 cmH(2)O, prior SUI, newborn weight > 2.988 g, and new onset of SUI in pregnancy predicted SUI. The model's accuracy was high (84%; p = 0.00).
CONCLUSIONS
From the four predictors identified, three are modifiable by physical therapy. This could be offered to women targeting at PFM strength >35.5 cmH(2)O at the postpartum as well as at the prevention of SUI before and during pregnancy.
引言与假设
本研究旨在调查压力性尿失禁（SUI）的产科、新生儿及临床预测因素，重点关注阴道分娩后盆底肌肉（PFM）力量。
方法
采用横断面研究，在产后5 - 7个月收集192名初产妇SUI的潜在预测因素。在双变量分析中具有显著意义的预测因素被纳入分类回归树，以确定它们之间的相互作用以及指导临床实践的截断点。
结果
PFM力量是SUI最强的预测因素。PFM力量≤35.5 cmH₂O、既往SUI、新生儿体重>2.988 g以及孕期新发性SUI共同预测SUI。该模型的准确性较高（84%；p = 0.00）。
结论
从确定的四个预测因素来看，其中三个可通过物理治疗进行调整。这可以针对产后PFM力量>35.5 cmH₂O的女性，以及在孕期前后预防SUI的女性提供。
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