Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Samanpazari, Turkey.
Department of General Surgery, Ankara Oncology Hospital, Yenimahalle, Turkey.
Physiother Theory Pract. 2022 Nov;38(11):1789-1798. doi: 10.1080/09593985.2021.1878568. Epub 2021 Jan 31.
Urinary incontinence (UI) is a common pelvic floor dysfunction in pregnancy. The relationship between biomechanical changes and pregnancy-related UI has not been fully elucidated.
To investigate the association of various musculoskeletal and anthropometric changes in pregnancy that affect gestational UI.
The study was conducted with 275 pregnant women. Ninety-three, 110 and 72 women were in first, second and third trimesters, respectively. Incontinence Impact Questionnaire for UI, Urogenital Distress Inventory-Short Form and Incontinence Severity Index were applied. Lumbar lordosis measurement was performed by Baseline Bubble Inclinometer while diastasis recti abdominis (DRA) measurement was carried out by finger-width method. Manual muscle test for rectus abdominis and right and left external oblique abdominal muscles, and Benign joint hypermobility test with Beighton scoring method were also applied as musculoskeletal measurements. Tape measurement at the waist, umbilical and hip levels, caliper with bi-iliac and bi-trochanteric diameters were also recorded as anthropometric measurements.
Significant associated factors for UI were: umbilical DRA (OR = 1.57; = .012); rectus abdominis muscle strength (values of 3 and below, OR = 1.2; = .014); umbilical environment (OR = 1.1; = .029); bi-iliac diameter (OR = 1.1; = .05;) and bi-trochanteric diameter (OR = 1.3; = .05), respectively.
Changing musculoskeletal and anthropometric characteristics of pregnant women should be taken into consideration in UI follow-up during pregnancy.
尿失禁（UI）是妊娠期间常见的盆底功能障碍。生物力学变化与妊娠相关性 UI 之间的关系尚未完全阐明。
研究妊娠期间影响妊娠性 UI 的各种骨骼肌肉和人体测量变化的相关性。
本研究共纳入 275 名孕妇。93、110 和 72 名孕妇分别处于妊娠早期、中期和晚期。应用尿失禁影响问卷（UI）、尿生殖窘迫量表-短表（Urogenital Distress Inventory-Short Form）和失禁严重程度指数（Incontinence Severity Index）进行评估。腰椎前凸度通过基线气泡倾斜计进行测量，而腹直肌分离（DRA）通过指宽法进行测量。还进行了腹直肌和左右外斜肌的徒手肌肉测试，以及采用 Beighton 评分法的良性关节过度活动测试。腰部、脐部和髋部的胶带测量，以及双髂嵴和双股骨颈的卡尺测量，也作为人体测量学测量进行记录。
与 UI 相关的显著因素有：脐部 DRA（OR=1.57； =0.012）；腹直肌肌力（值为 3 及以下，OR=1.2； =0.014）；脐部环境（OR=1.1； =0.029）；双髂嵴直径（OR=1.1； =0.05）和双股骨颈直径（OR=1.3； =0.05）。
在妊娠期间，应考虑孕妇骨骼肌肉和人体测量特征的变化，对 UI 进行随访。
