School of Medical Imaging, Bin Zhou Medical University, Yan Tai, People's Republic of China.
Department of Ultrasonography, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, People's Republic of China.
J Ultrasound Med. 2023 Oct;42(10):2331-2338. doi: 10.1002/jum.16257. Epub 2023 May 31.
We herein evaluated the effects of gestational weight gain (GWG) on postpartum pelvic floor function using transperineal ultrasound (TPUS).
We analyzed retrospectively the data from 228 primiparous women with singleton pregnancies who were evaluated for postpartum pelvic floor function between February 2022 and October 2022. According to the 2009 Institute of Medicine guidelines regarding GWG, subjects were separated into three groups: inadequate GWG, recommended GWG, and excessive GWG. All underwent TPUS 6-10 weeks postpartum to assess bladder neck descent between rest and Valsalva (BND), retrovesical angle at Valsalva (RVA), urethral rotation angle between rest and Valsalva (URA), the area of levator hiatus at Valsalva (LHA), and abnormal pelvic floor function. Univariate and multivariate regression analyses were applied to explore the association measures between GWG and the pelvic floor. A P-value <.05 was considered statistically significant.
Of the 228 primiparous women, 113 (49.6%) showed excessive GWG. Univariate analysis revealed that there were no statistical differences in ultrasonic parameters of the pelvic floor among the three groups (P > .05). After adjusting for potential confounders and using the recommended GWG group as a reference group, inadequate GWG was significantly associated with BND ≥25 mm (OR = 0.36, 95% CI = 0.14-0.93), and excessive GWG was significantly associated with uterine prolapse (OR = 2.79, 95% CI = 1.13-6.92).
GWG was associated with the ultrasonic parameters of the female pelvic floor in the early postpartum period.
本研究旨在通过经会阴超声（TPUS）评估妊娠期体重增加（GWG）对产后盆底功能的影响。
回顾性分析了 2022 年 2 月至 2022 年 10 月期间 228 例单胎妊娠初产妇的产后盆底功能评估数据。根据 2009 年美国医学研究所关于 GWG 的指南，将受试者分为三组：GWG 不足、推荐 GWG 和 GWG 过多。所有受试者均在产后 6-10 周接受 TPUS 检查，以评估静息和valsalva 动作时膀胱颈下降（BND）、valsalva 动作时膀胱后角（RVA）、静息和valsalva 动作时尿道旋转角（URA）、valsalva 动作时肛提肌裂孔面积（LHA）以及盆底功能异常。采用单变量和多变量回归分析探讨 GWG 与盆底功能之间的关联。P 值<.05 为差异有统计学意义。
228 例初产妇中，113 例（49.6%）存在 GWG 过多。单变量分析显示，三组间盆底超声参数无统计学差异（P>.05）。调整潜在混杂因素后，以推荐 GWG 组为参照组，GWG 不足与 BND≥25mm 显著相关（OR=0.36，95%CI=0.14-0.93），GWG 过多与子宫脱垂显著相关（OR=2.79，95%CI=1.13-6.92）。
GWG 与产后早期女性盆底的超声参数相关。
