Daly Deirdre, Cusack Cinny, Begley Cecily
School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, DO2 T283, Ireland.
Rotunda Hospital, Parnell Street, Dublin, D01 P5W9, Ireland.
Int Urogynecol J. 2019 Jun;30(6):965-975. doi: 10.1007/s00192-018-3848-3. Epub 2019 Jan 5.
All pregnant women should be given advice on the benefits of pelvic floor muscle exercises (PFMEs) in preventing urinary incontinence (UI) and know how to exercise correctly. This study explored women's knowledge and practice of PFMEs, their sources of knowledge and prevalence of UI before and during pregnancy.
We conducted a cross-sectional study with 567 women, 239 primiparous and 328 multiparous, recruited from one maternity hospital in Ireland. Logistic regression was used to examine associations.
Pre-pregnancy, 41% of women (n = 232) learnt to do PFMEs, 30% (n = 172) did exercises and 28% (n = 159) experienced UI. Women more likely to report UI were aged ≥ 35 years (p = 0.03), had a BMI ≥ 30 kg/m (p = 0.01) or did PFMEs but were unsure they were exercising correctly (p = 0.03). During pregnancy, 50% of women (n = 281) received PFME information during antenatal visits and 38.6% (n = 219) attended antenatal classes. Women less likely to do PFMEs daily or weekly had no formal educational qualification (p = 0.01), did not do PFMEs pre-pregnancy (p < 0.0001) or did not attend the physiotherapist-led PFME education session (p < 0.0001). In multivariable analysis, the two factors significantly associated with UI during pregnancy were being aged 30-34 years (p = 0.05) and reporting UI pre-pregnancy (p < 0.0001).
This benchmarking exercise revealed considerable gaps in the totality of PFME education and services offered in the site hospital. We recommend that others do likewise to enable learning from those who have addressed service deficits.
所有孕妇都应得到关于盆底肌肉锻炼(PFMEs)在预防尿失禁(UI)方面的益处的建议,并知道如何正确锻炼。本研究探讨了女性对PFMEs的知识和实践、她们的知识来源以及孕前和孕期尿失禁的患病率。
我们对从爱尔兰一家妇产医院招募的567名女性进行了横断面研究,其中初产妇239名,经产妇328名。采用逻辑回归分析来检验相关性。
孕前,41%的女性(n = 232)学会了进行PFMEs,30%(n = 172)进行了锻炼,28%(n = 159)经历过尿失禁。更有可能报告尿失禁的女性年龄≥35岁(p = 0.03)、体重指数≥30 kg/m²(p = 0.01)或进行了PFMEs但不确定自己锻炼是否正确(p = 0.03)。孕期,50%的女性(n = 281)在产前检查期间获得了PFMEs信息,38.6%(n = 219)参加了产前课程。不太可能每天或每周进行PFMEs的女性没有正规学历(p = 0.01)、孕前未进行PFMEs(p < 0.0001)或未参加物理治疗师主导的PFMEs教育课程(p < 0.0001)。在多变量分析中,与孕期尿失禁显著相关的两个因素是年龄在30 - 34岁之间(p = 0.05)和孕前报告有尿失禁(p < 0.0001)。
这项基准评估揭示了该定点医院在提供的PFMEs教育和服务整体方面存在相当大的差距。我们建议其他医院也这样做,以便向那些解决了服务不足问题的医院学习。