Svare Jens A, Hansen Bent B, Lose Gunnar
Department of Obstetrics and Gynaecology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730, Herlev, Denmark,
Int Urogynecol J. 2014 Jan;25(1):47-51. doi: 10.1007/s00192-013-2233-5. Epub 2013 Oct 2.
The objective was to examine the relationship between maternal and perinatal factors and the occurrence of stress (SUI) or mixed (MUI) urinary incontinence (UI) 1 year after the first vaginal delivery in primiparous women.
Participants in this prospective cohort were recruited consecutively from June 2003 to July 2005 from all eligible women who delivered in the department. A validated questionnaire, the International Consultation of Incontinence Questionnaire Short Form (ICIQ-SF) was completed by all participants 2-3 days after delivery, and a similar second questionnaire was filled out 1 year later. Additional data were obtained from the medical records. The first questionnaire was completed by 1,018 women (63 %) and the second by 859 women (84 %). The study group comprised the 575 women without any UI before the pregnancy and who had a vaginal delivery. The primary analysis comprised 117 women with either SUI or MUI 1 year after the vaginal delivery and 403 women without any UI.
In univariate analyses, the following factors were associated with SUI or MUI: prepregnancy body mass index (BMI) ≥ 30 (p < 0.05), UI during the pregnancy (p < 0.05), perineal lesions (p < 0.05), and anal sphincter tears (p = 0.05). Logistic regression analysis showed that SUI or MUI was strongly associated with UI during the pregnancy [adjusted odds ratio (OR) 4.7, 95 % confidence interval (CI) 2.9-7.7) and inversely associated with oxytocin augmentation (adjusted OR 0.5, 95 % CI 0.3-0.9).
SUI or MUI 1 year after the first vaginal delivery was strongly associated with UI during the pregnancy and inversely associated with oxytocin augmentation.
目的是研究初产妇首次阴道分娩后1年，孕产妇及围产期因素与压力性尿失禁（SUI）或混合性尿失禁（MUI）发生情况之间的关系。
本前瞻性队列研究的参与者于2003年6月至2005年7月从该科室所有符合条件的产妇中连续招募。所有参与者在产后2 - 3天完成一份经过验证的问卷，即国际尿失禁咨询问卷简表（ICIQ - SF），并在1年后填写类似的第二份问卷。从病历中获取其他数据。第一份问卷由1018名女性（63%）完成，第二份由859名女性（84%）完成。研究组包括575名妊娠前无任何尿失禁且经阴道分娩的女性。主要分析包括117名阴道分娩后1年出现SUI或MUI的女性和403名无任何尿失禁的女性。
在单因素分析中，以下因素与SUI或MUI相关：妊娠前体重指数（BMI）≥30（p < 0.05）、孕期尿失禁（p < 0.05）、会阴损伤（p < 0.05）和肛门括约肌撕裂（p = 0.05）。逻辑回归分析显示，SUI或MUI与孕期尿失禁密切相关[调整优势比（OR）4.7，95%置信区间（CI）2.9 - 7.7]，与缩宫素加强呈负相关（调整OR 0.5，95% CI 0.3 - 0.9）。
首次阴道分娩后1年出现的SUI或MUI与孕期尿失禁密切相关，与缩宫素加强呈负相关。
