Chi Xiaolei, Yu Shushu, Zhu Kun, Chen Yiyao, Chu Yi, Chen Xinliang
Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
Shanghai Key Laboratory of Embryo Original Disease, Shanghai, People's Republic of China.
Int J Womens Health. 2023 Jan 22;15:81-90. doi: 10.2147/IJWH.S390626. eCollection 2023.
This study sought to explore the obstetric factors affecting early postpartum pelvic floor function of primiparas after vaginal delivery.
We included 3362 primiparas who underwent postpartum re-examination in International Peace Maternity and Child Health Hospital at 42-60 days after delivery. The Glazer Protocol was used to evaluate their pelvic floor function, and univariate and multivariate logistic regression analyses were performed to identify obstetric factors that might affect it.
Forceps-assisted delivery significantly increased the risk of the decline in fast- and slow-twitch muscle strength in the early postpartum period when compared with natural vaginal delivery (P < 0.05). Women with a pre-pregnancy body mass index (BMI) of ≥18.5 kg/m had a decreased risk of decline in fast-twitch muscle strength than those with a pre-pregnancy BMI of <18.5 kg/m (P < 0.05). Women who had a pre-pregnancy BMI of 24.0 to <28.0 kg/m bore a decreased risk of decline in slow-twitch muscle strength than those with a pre-pregnancy BMI of <18.5 kg/m (P < 0.05). The risk of decline in fast-twitch muscle strength and slow-twitch muscle in women with anemia during pregnancy was significantly increased (P < 0.05); women with second-stage labors of >2 h had an increased risk of fast-twitch and slow-twitch muscle strength decline than those with <2 h (P < 0.05).
Both pre-pregnancy underweight and obesity may cause impairment of early postpartum pelvic floor function. Forceps delivery, anemia during pregnancy, and the length of second stage of labor are independent factors leading to pelvic floor function impairment.
本研究旨在探讨影响初产妇阴道分娩后早期盆底功能的产科因素。
我们纳入了3362例在国际和平妇幼保健院产后42 - 60天进行复查的初产妇。采用Glazer方案评估其盆底功能，并进行单因素和多因素逻辑回归分析，以确定可能影响盆底功能的产科因素。
与自然阴道分娩相比，产钳助产显著增加了产后早期快、慢肌肌力下降的风险（P < 0.05）。孕前体重指数（BMI）≥18.5 kg/m²的女性，其快肌肌力下降的风险低于孕前BMI < 18.5 kg/m²的女性（P < 0.05）。孕前BMI为24.0至<28.0 kg/m²的女性，其慢肌肌力下降的风险低于孕前BMI < 18.5 kg/m²的女性（P < 0.05）。孕期贫血的女性，其快肌肌力和慢肌肌力下降的风险显著增加（P < 0.05）；第二产程>2小时的女性，其快肌和慢肌肌力下降的风险高于<2小时的女性（P < 0.05）。
孕前体重过轻和肥胖均可能导致产后早期盆底功能受损。产钳助产、孕期贫血和第二产程时长是导致盆底功能受损的独立因素。
