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产后女性盆底肌肉力量与尿失禁和肛门失禁:一项横断面研究。

Women's pelvic floor muscle strength and urinary and anal incontinence after childbirth: a cross-sectional study.

作者信息

Zizzi Priscila Tavares, Trevisan Karina Fernandes, Leister Nathalie, Cruz Camila da Silva, Riesco Maria Luiza Gonzalez

机构信息

Universidade de São Paulo, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem, São Paulo, SP, Brazil.

Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, São Paulo, SP, Brazil.

出版信息

Rev Esc Enferm USP. 2017 Apr 10;51:e03214. doi: 10.1590/S1980-220X2016209903214.

DOI:10.1590/S1980-220X2016209903214
PMID:28403368
Abstract

OBJECTIVE

To analyse pelvic floor muscle strength (PFMS) and urinary and anal incontinence (UI and AI) in the postpartum period.

METHOD

Cross-sectional study carried out with women in their first seven months after child birth. Data were collected through interviews, perineometry (Peritron™), and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF).

RESULTS

128 women participated in the study. The PFMS mean was 33.1 (SD=16.0) cmH2O and the prevalence of UI and AI was 7.8% and 5.5%, respectively. In the multiple analyses, the variables associated with PFMS were type of birth and cohabitation with a partner. Newborn's weight, previous pregnancy, UI during pregnancy, and sexual activity showed an association with UI after child birth. Only AI prior to pregnancy was associated with AI after childbirth.

CONCLUSION

Vaginal birth predisposes to the reduction of PFMS, and caesarean section had a protective effect to its reduction. The occurrence of UI during pregnancy is a predictor of UI after childbirth, and women with previous pregnancies and newborns with higher weights are more likely to have UI after childbirth.AI prior to pregnancy is the only risk factor for its occurrence after childbirth. Associations between PFMS and cohabitation with a partner, and between UI and sexual activity do not make possible to conclude that these variables are directly associated.

OBJETIVO

Analisar a força dos músculos do assoalho pélvico e a incontinência urinária e anal no período pós-parto.

MÉTODO: Estudo transversal realizado com mulheres nos primeiros 7 meses após o parto. Os dados foram coletados por meio de entrevista, da perineometria (Peritron™) e do International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF).

RESULTADOS

Participaram do estudo 128 mulheres. A média da força dos músculos do assoalho pélvico foi 33,1 (d.p.=16,0) cmH2O e a prevalência de incontinência urinária e incontinência anal foi de 7,8% e 5,5%, respectivamente. Na análise múltipla, as variáveis associadas à força dos músculos do assoalho pélvico foram tipo de parto atual e coabitação com o parceiro. Peso do recém-nascido, gestação anterior, incontinência urinária na gestação e atividade sexual mostraram associação. Apenas a incontinência anal prévia à gestação associou-se à incontinência anal após o parto.

CONCLUSÃO: O parto vaginal predispõe à redução da força dos músculos do assoalho pélvico, e a cesariana exerce função protetora à sua redução. A ocorrência de incontinência urinária na gestação é preditora da incontinência urinária após o parto, e as mulheres com gestação anterior e recém-nascido de maior peso têm maior propensão em apresentar incontinência urinária após o parto. Incontinência anal prévia à gestação é o único fator de risco para sua ocorrência após o parto. As associações entre força dos músculos do assoalho pélvico e coabitação com o parceiro e entre incontinência urinária e atividade sexual não permitem concluir que essas variáveis estejam diretamente relacionadas.

摘要

目的

分析产后盆底肌肉力量(PFMS)以及尿失禁和肛门失禁(UI和AI)情况。

方法

对产后头七个月的女性进行横断面研究。通过访谈、会阴测量法(Peritron™)和国际尿失禁咨询问卷简表(ICIQ-SF)收集数据。

结果

128名女性参与了该研究。PFMS平均值为33.1(标准差=16.0)cmH₂O,UI和AI的患病率分别为7.8%和5.5%。在多因素分析中,与PFMS相关的变量是分娩类型和与伴侣同居情况。新生儿体重、既往妊娠、孕期UI以及性活动与产后UI有关联。只有妊娠前的AI与产后AI有关联。

结论

阴道分娩易导致PFMS下降,剖宫产对其下降有保护作用。孕期发生UI是产后UI的一个预测因素,既往有过妊娠且新生儿体重较大的女性产后更易发生UI。妊娠前的AI是产后发生AI的唯一风险因素。PFMS与与伴侣同居情况之间以及UI与性活动之间的关联无法得出这些变量直接相关的结论。

目的

分析产后盆底肌肉力量及尿失禁和肛门失禁情况。

方法

对产后头7个月的女性进行横断面研究。通过访谈、会阴测量(Peritron™)和国际尿失禁咨询问卷简表(ICIQ-SF)收集数据。

结果

128名女性参与了研究。盆底肌肉力量平均值为33.1(标准差=16.0)cmH₂O,尿失禁和肛门失禁的患病率分别为7.8%和5.5%。在多因素分析中,与盆底肌肉力量相关的变量是当前分娩类型和与伴侣同居情况。新生儿体重、既往妊娠、孕期尿失禁和性活动显示有关联。只有妊娠前的肛门失禁与产后肛门失禁有关联。

结论

阴道分娩易导致盆底肌肉力量下降,剖宫产对其下降起到保护作用。孕期发生尿失禁是产后尿失禁的预测因素,既往有过妊娠且新生儿体重较大的女性产后更易出现尿失禁。妊娠前的肛门失禁是产后发生肛门失禁的唯一风险因素。盆底肌肉力量与与伴侣同居情况之间以及尿失禁与性活动之间的关联无法得出这些变量直接相关的结论。

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