Department of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Währinger Gürtel 18-20, Vienna, 1090, Austria.
Department of Special Gynecology and Obstetrics, Karl Landsteiner Institute, Vienna, Austria.
Arch Gynecol Obstet. 2019 Nov;300(5):1325-1330. doi: 10.1007/s00404-019-05311-9. Epub 2019 Oct 10.
To investigate the prevalence of pelvic floor disorders (PFDs) in a cohort of Austrian women either during their early or late pregnancy and to search for clinical risk factors which correlate with pelvic floor symptoms during pregnancy.
A prospective study was conducted and 200 pregnant women answered the validated German pelvic floor questionnaire during their first or third trimenon of gestation. Furthermore, a multivariate logistic regression model was used to determine independent risk factors for PFDs after adjusting for confounders.
96/200 (48%) women reported psychological strain in at least 1 of the 4 pelvic floor domains while the remaining 104 women (52%) were asymptomatic. Affected women showed a significant higher BMI, a more frequent positive family history and a higher rate of multiple pregnancies was noted compared to asymptomatic women (p < 0.05). Furthermore, a statistically significant positive correlation could be observed between BMI, smoking and mean bladder score as well as mean prolapse score, signifying more symptom bother from bladder and prolapse in smokers with high BMI. A significant positive correlation was also detected between mean bowel score and parity. In the multivariate model, high BMI (CI 1.013-1.143), positive family history (CI 0.044-0.260) and multiple pregnancies (CI 0.011-0.244) remained independently associated with pelvic floor symptoms (p < 0.05).
Our results demonstrate that pelvic floor-related quality of life during pregnancy is a prevalent condition which is strongly affected by the expectant mother's weight as well as her family history. In addition, women with multiple pregnancies seem to be at increased risk.
调查奥地利女性在早期或晚期妊娠期间盆底功能障碍(PFD)的患病率,并寻找与妊娠期间盆底症状相关的临床危险因素。
进行了一项前瞻性研究,200 名孕妇在妊娠第 1 或第 3 个三个月期间回答了经过验证的德国盆底问卷。此外,使用多元逻辑回归模型确定 PFD 的独立危险因素,同时调整了混杂因素。
96/200(48%)名女性报告在至少 1 个盆底领域存在心理压力,而其余 104 名女性(52%)无症状。与无症状女性相比,受影响的女性 BMI 更高,阳性家族史更频繁,多胎妊娠率更高(p<0.05)。此外,BMI、吸烟和平均膀胱评分以及平均脱垂评分之间可以观察到统计学上显著的正相关,表明 BMI 较高的吸烟者的膀胱和脱垂症状更严重。平均肠评分与产次之间也存在显著的正相关。在多元模型中,高 BMI(CI 1.013-1.143)、阳性家族史(CI 0.044-0.260)和多胎妊娠(CI 0.011-0.244)仍然与盆底症状独立相关(p<0.05)。
我们的研究结果表明,妊娠期间与盆底相关的生活质量是一种普遍存在的情况,它受到孕妇体重以及家族史的强烈影响。此外,多胎妊娠的女性似乎风险增加。