Islam R M, Bell R J, Billah B, Hossain M B, Davis S R
a Women's Health Research Program, School of Public Health and Preventive Medicine , Monash University , Melbourne , Victoria , Australia.
b Department of Population Sciences , University of Dhaka , Dhaka , Bangladesh.
Climacteric. 2016 Dec;19(6):558-564. doi: 10.1080/13697137.2016.1240771. Epub 2016 Oct 20.
To investigate the prevalence of, and risk factors for, pelvic floor disorders (PFDs) in women in Bangladesh.
A nationally representative sample of 1590 Bangladeshi women, aged 30-59 years, was recruited using a multistage cluster sampling technique, between September 2013 and March 2014. Urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) were assessed using validated questionnaires. The weighted prevalence and the factors associated with each PFD were investigated using multivariable weighted logistic regression.
The weighted prevalence of UI was 23.7% (95% confidence interval (CI) 21.3-26.0%), FI 5.3% (95% CI 4.0-6.6%), POP 16.2% (95% CI 14.2-18.2%), and having at least one PFD 35.3% (95% CI 32.6-37.9%). Women were more likely to have at least one PFD if aged 40-49 years (adjusted odds ratio (AOR) 1.46, 95% CI 1.02-2.08; p = 0.040) or 50-59 years (AOR 2.39, 95% CI 1.59-3.58; p < 0.0001), compared with women aged 30-39 years. Having at least one PFD was positively associated with having three or more versus fewer children (AOR 1.61, 95% CI 1.14-2.27; p = 0.007), being in the middle (AOR 3.05, 95% CI 1.72-5.41; p < 0.0001), second lowest (AOR 2.49, 95% CI 1.39-4.47; p = 0.002) or lowest (AOR 3.13, 95% CI 1.68-5.86; p < 0.0001) wealth quintile compared with the highest, and self-reporting diabetes (AOR 2.55, 95% CI 1.54-4.23; p < 0.0001).
One-third of Bangladeshi women aged 30-59 years had at least one symptomatic PFD. Risk factors included greater age, higher parity, lower wealth status and self-reported diabetes. The diagnosis, treatment, and prevention of PFDs in Bangladesh need greater attention, as the prevalence of these disabling conditions is likely to increase with the aging of the population.
调查孟加拉国女性盆底功能障碍（PFDs）的患病率及其危险因素。
2013年9月至2014年3月期间，采用多阶段整群抽样技术，选取了1590名年龄在30 - 59岁之间、具有全国代表性的孟加拉国女性样本。使用经过验证的问卷对尿失禁（UI）、粪失禁（FI）和盆腔器官脱垂（POP）进行评估。采用多变量加权逻辑回归研究每种PFD的加权患病率及其相关因素。
UI的加权患病率为23.7%（95%置信区间（CI）21.3 - 26.0%），FI为5.3%（95% CI 4.0 - 6.6%），POP为16.2%（95% CI 14.2 - 18.2%），至少有一种PFD的患病率为35.3%（95% CI 32.6 - 37.9%）。与30 - 39岁的女性相比，40 - 49岁（调整优势比（AOR）1.46，95% CI 1.02 - 2.08；p = 0.040）或50 - 59岁（AOR 2.39，95% CI 1.59 - 3.58；p < 0.0001）的女性更有可能至少有一种PFD。与孩子数量较少相比，生育三个或更多孩子（AOR 1.61，95% CI 1.14 - 2.27；p = 0.007）、处于中等（AOR 3.05，95% CI 1.72 - 5.41；p < 0.0001）、第二低（AOR 2.49，95% CI 1.39 - 4.47；p = 0.002）或最低（AOR 3.13，95% CI 1.68 - 5.86；p < 0.0001）财富五分位数（与最高相比）以及自我报告患有糖尿病（AOR 2.55，95% CI 1.54 - 4.23；p < 0.0001）与至少有一种PFD呈正相关。
30 - 59岁的孟加拉国女性中有三分之一至少有一种有症状的PFD。危险因素包括年龄较大、生育次数较多、财富状况较低以及自我报告患有糖尿病。由于这些致残性疾病的患病率可能会随着人口老龄化而增加，孟加拉国对PFDs的诊断、治疗和预防需要更多关注。
