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决定产前压力性尿失禁 12 个月后持续性的因素。

Factors determining the persistence of prenatal stress urinary incontinence 12 months postpartum.

机构信息

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Department of Health Care Management, College of Management, Chang Gung University, Tao-Yuan, Taiwan; Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

出版信息

Taiwan J Obstet Gynecol. 2023 Jan;62(1):40-44. doi: 10.1016/j.tjog.2022.10.003.

Abstract

OBJECTIVE

Whilst many studies have explored the mechanisms of stress urinary incontinence (SUI) following various modes of delivery, few have examined outcomes of postpartum SUI in women who experienced new-onset SUI during their pregnancy. Our primary objective was to investigate the risk factors for persistent postpartum SUI in women with new-onset SUI during pregnancy at 1-year follow-up following vaginal delivery.

MATERIALS AND METHODS

303 women with new-onset SUI during pregnancy who underwent vaginal delivery in a university hospital between 2014 and 2015 were included. In-person interviews were conducted for all participants on the second postpartum day, followed by phone interviews at 12 months postpartum, with completion of structured questionnaires, including Urogenital Distress Inventory Short Form (UDI-6) and Incontinence Impact Questionnaire Short Form (IIQ-7). Demographic, obstetrics and questionnaire scores were analyzed and compared between the group of women who experienced persistent postpartum SUI and the group who did not.

RESULTS

At 12 months postpartum, 16.5% (n = 50) of women had persistent postpartum SUI, with 83.5% (n = 253) experiencing resolution of SUI symptoms. Maternal age ≥35 years (aOR = 2.62; 95% CI, 1.40-4.87, P = 0.002), gestational age at birth ≥40 weeks (aOR = 2.21; 95% CI, 1.12-4.37, P = 0.022), and severe perineal lacerations (aOR = 2.32; 95% CI, 1.27-4.45, P = 0.013) were independent risk factors for persistent postpartum SUI for women following vaginal delivery at 1-year follow-up.

CONCLUSION

The prevalence of persistent postpartum SUI at 1-year following vaginal delivery is 16.5%, with advanced maternal age, gestational age at birth ≥40 weeks and severe perineal lacerations being independent risk factors.

摘要

目的

尽管许多研究已经探讨了各种分娩方式后压力性尿失禁(SUI)的机制,但很少有研究调查在怀孕期间新发生 SUI 的女性产后 SUI 的结局。我们的主要目的是研究在阴道分娩后 1 年随访时,患有妊娠期间新发 SUI 的女性中持续性产后 SUI 的危险因素。

材料与方法

2014 年至 2015 年期间,我们在一家大学医院纳入了 303 名患有妊娠期间新发 SUI 的女性。所有参与者在产后第二天进行面对面访谈,然后在产后 12 个月进行电话访谈,完成包括尿失禁生活质量问卷(Urogenital Distress Inventory Short Form,UDI-6)和尿失禁影响问卷(Incontinence Impact Questionnaire Short Form,IIQ-7)在内的结构化问卷。对人口统计学、产科和问卷评分进行分析,并比较持续性产后 SUI 组和未发生持续性产后 SUI 组之间的差异。

结果

产后 12 个月时,16.5%(n=50)的女性患有持续性产后 SUI,83.5%(n=253)的女性 SUI 症状缓解。母亲年龄≥35 岁(OR=2.62;95%CI,1.40-4.87,P=0.002)、分娩时的胎龄≥40 周(OR=2.21;95%CI,1.12-4.37,P=0.022)和严重会阴裂伤(OR=2.32;95%CI,1.27-4.45,P=0.013)是阴道分娩后 1 年随访时持续性产后 SUI 的独立危险因素。

结论

阴道分娩后 1 年持续性产后 SUI 的患病率为 16.5%,年龄较大、分娩时胎龄≥40 周和严重会阴裂伤是独立的危险因素。

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