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预测初产妇产后压力性尿失禁风险的列线图模型:一项多中心研究。

A nomogram model predicting the risk of postpartum stress urinary incontinence in primiparas: A multicenter study.

机构信息

School of Medical Nursing, Fuyang Institute of Technology, Fuyang City 236031, Anhui Province, China.

Fuyang Women and Children's Hospital, Fuyang City 236000, Anhui Province, China.

出版信息

Taiwan J Obstet Gynecol. 2022 Jul;61(4):580-584. doi: 10.1016/j.tjog.2022.04.004.

DOI:10.1016/j.tjog.2022.04.004
PMID:35779903
Abstract

Stress urinary incontinence (SUI) is a common gynecological urinary system disease, and globally, 200 million or more people suffer from it. However, the existing literature mostly focuses on postpartum urinary incontinence (UI) or UI in middle-aged and elderly people, with little focus on primiparas. To analyse urinary incontinence prevalence and its risk factors in primiparas and establish a nomogram prediction model, 360 parturients were recruited from three hospitals between April and September 2021. A homemade electronic questionnaire was used to investigate the general demographic and perinatal characteristics of primiparas. The SUI was diagnosed by the physicians. Logistic regression analysis of independent risk factors for SUI and a nomogram prediction model were established. Ninety people were diagnosed as SUI. The number of pregnancies (OR = 3.322, 95% CI = 1.473-7.492), residence (OR = 5.451, 95% CI = 2.725-10.903), occupation (OR = 3.393, 95% CI = 1.144-10.064), education level (OR = 3.551, 95% CI = 1.223-10.308), delivery method (OR = 10.270, 95% CI = 4.090-25.789), and oxytocin use (OR = 2.166, 95% CI = 1.142-4.109) were independent risk factors for SUI. The C-index of the nomogram prediction model was 0.798 (95% CI = 0.749-0.846). The POPDI score, CRADI score, UDI score, and PFDI scores of women with SUI were significantly higher than those of non-SUI women, while I-QOL scores were significantly lower than those of non-SUI women. In conclusion, the prevalence of SUI among primiparas in Fuyang, China, was 25.00%, which exhibited a large impact on the quality of life of puerperae. The present study successfully established an individualized nomogram prediction model of SUI for primiparas with good discrimination and diagnostic efficiency, which was helpful for the early clinical identification of high-risk primiparas with SUI.

摘要

压力性尿失禁(SUI)是一种常见的妇科泌尿系统疾病,全球有 2 亿多人患有这种疾病。然而,现有文献主要集中在产后尿失禁(UI)或中老年 UI 上,很少关注初产妇。为了分析初产妇尿失禁的患病率及其危险因素,并建立一个列线图预测模型,我们从 2021 年 4 月至 9 月在三家医院招募了 360 名产妇。使用自制的电子问卷调查初产妇的一般人口统计学和围产期特征。由医生诊断 SUI。对 SUI 的独立危险因素进行 logistic 回归分析,并建立列线图预测模型。90 人被诊断为 SUI。妊娠次数(OR=3.322,95%CI=1.473-7.492)、居住地(OR=5.451,95%CI=2.725-10.903)、职业(OR=3.393,95%CI=1.144-10.064)、教育程度(OR=3.551,95%CI=1.223-10.308)、分娩方式(OR=10.270,95%CI=4.090-25.789)和催产素使用(OR=2.166,95%CI=1.142-4.109)是 SUI 的独立危险因素。列线图预测模型的 C 指数为 0.798(95%CI=0.749-0.846)。SUI 妇女的 POPDI 评分、CRADI 评分、UDI 评分和 PFDI 评分显著高于非 SUI 妇女,而 I-QOL 评分显著低于非 SUI 妇女。总之,中国阜阳初产妇的 SUI 患病率为 25.00%,对产妇的生活质量有较大影响。本研究成功建立了初产妇 SUI 的个体化列线图预测模型,具有良好的判别和诊断效率,有助于临床早期识别 SUI 的高危初产妇。

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