a Midwifery Department, Menopause and Andropause Research Center , Ahvaz Jundishapur University of Medical Sciences , Ahvaz , Iran.
b Department of Midwifery , Razi School of Nursing and Midwifery, Kerman University of Medical Sciences , Kerman , Iran.
Climacteric. 2017 Aug;20(4):362-366. doi: 10.1080/13697137.2017.1315087. Epub 2017 Apr 25.
Many postmenopausal women suffer from genitourinary syndrome of menopause (GSM) due to the lack of estrogen. This study aimed to evaluate the relationship between mode of delivery and GSM among postmenopausal women.
We performed a case-control study of women who had had either vaginal delivery or Cesarean section. Data were collected through a sociodemographic questionnaire and a check list for assessing signs and symptoms of GSM. Subjective symptoms of vaginal atrophy (dryness, dyspareunia, itching, burning and paleness), pH of the vagina and maturation index were assessed and recorded. Data were analyzed using the χ test and independent t-test.
A total of 125 postmenopausal women were recruited (65 with a history of normal vaginal delivery (NVD) and 60 with a history of Cesarean section). Vaginal pH was more commonly lower (pH 5-5.49) in the NVD group (50.8% vs. 40%) (p < 0.001). The maturation index was also better in the NVD group (42.7 ± 6.34 vs. 24.08 ± 8.2) (p < 0.001). All symptoms of vaginal atrophy including paleness, dryness, itching, dyspareunia and burning were significantly less in the NVD group compared to the Cesarean section group (p < 0.05).
Postmenopausal women with a history of normal vaginal delivery were less likely to have GSM compared to the women with a history of Cesarean section. Other prospective studies can explore this relationship better.
许多绝经后妇女由于缺乏雌激素而患有女性生殖泌尿系统绝经后综合征（GSM）。本研究旨在评估分娩方式与绝经后妇女 GSM 之间的关系。
我们对经阴道分娩或剖宫产的妇女进行了病例对照研究。通过社会人口学问卷和评估 GSM 体征和症状的检查表收集数据。评估并记录阴道萎缩的主观症状（干燥、性交困难、瘙痒、灼热和苍白）、阴道 pH 值和成熟指数。使用 χ 检验和独立 t 检验分析数据。
共招募了 125 名绝经后妇女（65 名有正常阴道分娩史（NVD），60 名有剖宫产史）。NVD 组阴道 pH 值更常见（pH 值 5-5.49）（50.8%比 40%）（p<0.001）。NVD 组的成熟指数也更好（42.7±6.34 比 24.08±8.2）（p<0.001）。与剖宫产组相比，NVD 组所有阴道萎缩症状（包括苍白、干燥、瘙痒、性交困难和灼热）均明显较少（p<0.05）。
与剖宫产史的妇女相比，有正常阴道分娩史的绝经后妇女 GSM 的可能性较低。其他前瞻性研究可以更好地探讨这种关系。
