Department of Obstetrics and Gynecology, Soroka Medical Center, Beer-Sheva, Israel.
Pediatric Dermatology Services, Soroka Medical Center, Beer-Sheva, Israel.
Int Urogynecol J. 2022 Dec;33(12):3441-3447. doi: 10.1007/s00192-022-05249-8. Epub 2022 Jun 6.
Striae gravidarum are linear atrophic scars appearing on the abdomen of pregnant women reported to be related to pregnancy-induced changes in the connective tissue. Pelvic floor distress symptoms are also known to be linked to connective tissue weakness. Given that common pathophysiological pathways may play a role in both striae gravidarum and pelvic floor dysfunction symptoms, we sought to examine whether there is a correlation between them during pregnancy.
A prospective observational study among third-trimester pregnant women who visited a tertiary medical center for routine pregnancy follow-up was conducted by using the Pelvic Floor Distress Inventory (PFDI-20) questionnaire to evaluate pelvic floor distress symptoms and the Davey method for evaluating striae gravidarum severity. Obstetrical characteristics as well as pelvic floor distress symptoms were compared between two groups according to the severity of striae gravidarum. Univariate analysis was carried out using appropriate tests; PFDI scores were compared between the groups using the Mann-Whitney test.
Women with striae gravidarum were significantly older (31.06 vs. 28.83 years, p < 0.01), had a lower body mass index (27.5 vs. 30.98, p < 0.01), and gave birth to smaller neonates (3155 vs. 3389 g, p < 0.01). In addition, the overall and median PFDI-20 scores differed between the groups (with severe SG having the highest median score of 20 and those with milder SG having a score of 16 compared to 14 in those without SG). A distinct association between the PFDI-20 score and SG severity was not demonstrated (p = 0.63).
In our population, an association was demonstrated between pelvic floor distress symptoms and the presence of striae gravidarum. However, following a linear regression model, no statistically significant association between SG severity and total PFD-20 score was seen. Our findings strengthen the hypothesis of common connective tissue involvement in the pathophysiology of both conditions.
妊娠纹是孕妇腹部出现的线性萎缩性瘢痕，据报道与妊娠引起的结缔组织变化有关。盆底窘迫症状也与结缔组织薄弱有关。鉴于常见的病理生理途径可能在妊娠纹和盆底功能障碍症状中都发挥作用，我们试图在妊娠期间检查它们之间是否存在相关性。
对在三级医疗中心进行常规妊娠随访的第三孕期孕妇进行前瞻性观察性研究，使用盆底窘迫问卷（PFDI-20）评估盆底窘迫症状，并用 Davey 方法评估妊娠纹严重程度。根据妊娠纹严重程度将两组孕妇的产科特征和盆底窘迫症状进行比较。采用适当的检验进行单变量分析；采用 Mann-Whitney 检验比较两组的 PFDI 评分。
患有妊娠纹的女性年龄明显较大（31.06 岁比 28.83 岁，p<0.01），体重指数较低（27.5 比 30.98，p<0.01），新生儿体重较小（3155 克比 3389 克，p<0.01）。此外，两组的总体和中位数 PFDI-20 评分存在差异（严重 SG 的中位数评分最高为 20，轻度 SG 的中位数评分为 16，而无 SG 的中位数评分为 14）。PFDI-20 评分与 SG 严重程度之间没有明显的相关性（p=0.63）。
在我们的人群中，盆底窘迫症状与妊娠纹的存在之间存在相关性。然而，在进行线性回归模型后，SG 严重程度与总 PFD-20 评分之间未见统计学显著相关性。我们的研究结果加强了常见结缔组织参与两种疾病病理生理的假说。
