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产后2年内尿失禁的患病率及危险因素:一项基于人群的横断面研究。

Prevalence and risk factors for urinary incontinence up to 2 years postpartum: a cross-sectional population-based study.

作者信息

Bonasia Kyra, Clancy Aisling, Stairs Jocelyn

机构信息

Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa, Canada.

Department of Obstetrics and Gynecology, Dalhousie University, 5980 University Avenue, P.O. Box 9700, Halifax, NS, 5850B3K 6R8, Canada.

出版信息

Int Urogynecol J. 2023 Oct;34(10):2467-2472. doi: 10.1007/s00192-023-05571-9. Epub 2023 May 18.

Abstract

INTRODUCTION AND HYPOTHESIS

Urinary incontinence (UI) is common in the postpartum period; however, most studies focus on the early postpartum period and assess prevalence at only one or two time points. We hypothesized that UI would be prevalent across the first 2 years postpartum. Our secondary objective was to evaluate risk factors for postpartum UI among a nationally representative, contemporary sample.

METHODS

This cross-sectional, population-based study used National Health and Nutrition Examination Survey (2011-2018) data for parous women within 24 months following delivery. Prevalence of UI, UI subtypes, and severity were estimated. Multivariate logistic regression was used to estimate adjusted odds (aOR) of UI for exposures of interest.

RESULTS

Among 560 postpartum women, prevalence of any UI was 43.5%. Stress UI was most common (28.7%), and most women (82.8%) experienced mild symptoms. There was no significant change in prevalence of UI across the 24 months following delivery (R = 0.004). Individuals with postpartum UI tended to be older (30.3 ± 0.5 versus 28.8 ± 0.5 years) and had higher BMI (31.1 ± 0.6 versus 28.9 ± 0.6). In multivariate analysis, odds of postpartum UI were higher for women who had had a prior vaginal delivery (aOR 2.0, 95% CI: 1.3-3.3), prior delivery of a baby weighing 9 lb (4 kg) or more (aOR 2.5, 95% CI: 1.3-4.8), or who reported current smoking (aOR 1.5, 95% CI: 1.0-2.3).

CONCLUSIONS

During the first 2 years postpartum 43.5% of women report UI, with relatively stable prevalence over this period. This high prevalence supports screening for UI after delivery regardless of risk factors.

摘要

引言与假设

尿失禁(UI)在产后时期很常见;然而,大多数研究集中在产后早期,且仅在一两个时间点评估患病率。我们假设尿失禁在产后的头两年都很普遍。我们的次要目标是在一个具有全国代表性的当代样本中评估产后尿失禁的危险因素。

方法

这项基于人群的横断面研究使用了国家健康和营养检查调查(2011 - 2018年)中分娩后24个月内的经产妇数据。估计了尿失禁、尿失禁亚型和严重程度的患病率。多因素逻辑回归用于估计感兴趣暴露因素导致尿失禁的调整后比值(aOR)。

结果

在560名产后女性中,任何类型尿失禁的患病率为43.5%。压力性尿失禁最常见(28.7%),且大多数女性(82.8%)症状较轻。分娩后的24个月内尿失禁患病率无显著变化(R = 0.004)。产后有尿失禁的个体往往年龄较大(30.3 ± 0.5岁对28.8 ± 0.5岁)且体重指数较高(31.1 ± 0.6对28.9 ± 0.6)。在多因素分析中,既往有阴道分娩史的女性产后尿失禁的几率更高(aOR 2.0,95%可信区间:1.3 - 3.3),既往分娩过体重9磅(4千克)或更重婴儿的女性(aOR 2.5,95%可信区间:1.3 - 4.8),或报告当前吸烟的女性(aOR 1.5,95%可信区间:1.0 - 2.3)。

结论

在产后的头两年,43.5%的女性报告有尿失禁,在此期间患病率相对稳定。这种高患病率支持无论有无危险因素都应在产后进行尿失禁筛查。

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