Ng Karen, Cheung Rachel Yau Kar, Lee Lai Loi, Chung Tony Kwok Hung, Chan Symphorosa Shing Chee
Department of Obstetrics & Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong.
Int Urogynecol J. 2017 Sep;28(9):1393-1399. doi: 10.1007/s00192-017-3281-z. Epub 2017 Feb 14.
This study aimed to determine the prevalence of urinary incontinence (UI), fecal incontinence (FI), and pelvic organ prolapse (POP) 3-5 years after the first pregnancy and their associated risk factors.
We assessed 506 women using the Pelvic Floor Distress Inventory (PFDI) and the Pelvic Floor Impact Questionnaire (PFIQ). Maternal characteristics and obstetric data were analyzed using descriptive analysis, independent sample t test, chi-squared test, and logistic regression.
The prevalence of UI, FI, and POP, respectively, at a mean of 43 months after first delivery was 40.8, 6.6, and 10.2% following vaginal delivery (VD) and 22.7, 4.5, and 4.5% following cesarean section (CS). Stress urinary incontinence (SUI) was reported by more women following VD than CS (38.7 vs 22.4%, P = 0.010). Compared with 8 weeks' postpartum, more women reported SUI at this later follow-up visit (40.1 vs 19.5%, P < 0.001), but fewer reported FI. More women who had an instrumental delivery reported symptoms of POP compared with those who had a normal VD. Higher body weight and weight gain from first trimester were risk factors of SUI [odds ratio (OR) 1.03] and urge urinary incontinence (UUI) (OR 1.18), respectively. Women who delivered vaginally had higher PFDI subscales scores.
VD increased UI risk. Higher body weight and weight gain from first trimester were risk factors for SUI and UUI, respectively. More women reported symptoms of POP following an instrumental delivery than those who had a normal VD.
本研究旨在确定首次妊娠后3至5年尿失禁（UI）、粪失禁（FI）和盆腔器官脱垂（POP）的患病率及其相关危险因素。
我们使用盆底功能障碍量表（PFDI）和盆底功能影响问卷（PFIQ）对506名女性进行了评估。采用描述性分析、独立样本t检验、卡方检验和逻辑回归分析产妇特征和产科数据。
首次分娩后平均43个月时，经阴道分娩（VD）后UI、FI和POP的患病率分别为40.8%、6.6%和10.2%，剖宫产（CS）后分别为22.7%、4.5%和4.5%。VD后报告压力性尿失禁（SUI）的女性多于CS后（38.7%对22.4%，P = 0.010）。与产后8周相比，本次后期随访时报告SUI的女性更多（40.1%对19.5%，P < 0.001），但报告FI的女性更少。器械助产的女性比正常VD的女性报告POP症状的更多。较高的体重和孕早期体重增加分别是SUI（优势比[OR] 1.03）和急迫性尿失禁（UUI）（OR 1.18）的危险因素。经阴道分娩的女性PFDI子量表得分更高。
VD增加了UI风险。较高的体重和孕早期体重增加分别是SUI和UUI的危险因素。器械助产的女性比正常VD的女性报告POP症状的更多。
