Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P. R. China.
Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing, P. R. China.
Neurourol Urodyn. 2019 Feb;38(2):793-800. doi: 10.1002/nau.23922. Epub 2019 Jan 15.
To investigate the extent of lower urinary tract symptoms (LUTS) during pregnancy and 7 years after birth in primipara and their association with delivery mode history and other factors.
A longitudinal cohort study was conducted in 12 hospitals representative of the diversity of the seven administrative regions of China. Of 10 098 women recruited at the third trimester, 3862 (38.25%) responded at 1 year, and 1115 (11.04%) responded at 7 years. A modified Chinese Bristol Female Lower Urinary Tract Symptoms questionnaire was administered. No intervention was implemented.
Among the participants, 75.4% reported nocturia during gestation, followed by frequency (58.4%), which gradually decreased after delivery. The prevalence of urge urinary incontinence (UUI) increased from 5.7% during pregnancy to 22.8% at 1 year after delivery and 10.2% at 7 years postpartum. The prevalence of stress urinary incontinence (SUI) increased from 29.9% during pregnancy to 46.4% at 1 year postpartum and 23.7% at 7 years after delivery. The odds of storage LUTS and voiding LUTS 7 years after delivery were lower for the cesarean section (CS) group than for the vaginal delivery (VD) group (OR = 0.49, 95%CI, 0.36-0.68; OR = 0.25, 95%CI, 0.09-0.70). The most frequent moderately to severely bothersome LUTS after VD was SUI (19.18%), while that for CS was UUI (19.18%).
The incidence of storage LUTS was higher than that of voiding LUTS both during pregnancy and postpartum. The most frequently reported LUTS during pregnancy were nocturia and frequency, while the most frequent LUTS after delivery were urgency and SUI. CS was associated with a decreased prevalence of both storage and voiding LUTS after delivery.
探讨初产妇妊娠及产后 7 年时下尿路症状（LUTS）的严重程度及其与分娩方式史和其他因素的关系。
本研究采用了在中国 7 个行政区域内的 12 家医院进行的纵向队列研究。在招募的 10098 名孕妇中，有 3862 名（38.25%）在 1 年时进行了应答，1115 名（11.04%）在产后 7 年时进行了应答。采用改良后的中国布里斯托女性下尿路症状问卷进行调查。未实施任何干预措施。
在参与者中，75.4%在妊娠期间报告有夜尿症，其次是尿频（58.4%），这一比例在分娩后逐渐下降。急迫性尿失禁（UUI）的患病率从妊娠时的 5.7%增加到产后 1 年的 22.8%和产后 7 年的 10.2%。压力性尿失禁（SUI）的患病率从妊娠时的 29.9%增加到产后 1 年的 46.4%和产后 7 年的 23.7%。与阴道分娩（VD）组相比，剖宫产（CS）组产后 7 年时储存型和排尿型 LUTS 的可能性更低（OR=0.49，95%CI，0.36-0.68；OR=0.25，95%CI，0.09-0.70）。VD 后最常见的中至重度困扰性 LUTS 是 SUI（19.18%），而 CS 后最常见的是 UUI（19.18%）。
妊娠和产后时，储存型 LUTS 的发生率均高于排尿型 LUTS。妊娠期间最常见的 LUTS 是夜尿症和尿频，而产后最常见的 LUTS 是尿急和 SUI。CS 与产后储存型和排尿型 LUTS 的发生率降低有关。
