Perinatal Diabetes Research Center, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil.
Department of Health Sciences, Universidade Sagrado Coração, Bauru, São Paulo, Brazil.
Rev Bras Ginecol Obstet. 2023 Jun;45(6):303-311. doi: 10.1055/s-0043-1770087. Epub 2023 Jul 21.
The lack of data on the impact of hyperglycemia and obesity on the prevalence of pregnancy-specific urinary incontinence (PSUI) led us to conduct a cross-sectional study on the prevalence and characteristics of PSUI using validated questionnaires and clinical data.
This cross-sectional study included 539 women with a gestational age of 34 weeks who visited a tertiary university hospital between 2015 and 2018. The main outcome measures were the prevalence of PSUI, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Incontinence Severity Index (ISI) questionnaires. The women were classified into four groups: normoglycemic lean, normoglycemic obese, hyperglycemic lean, and hyperglycemic obese. The differences between groups were tested using descriptive statistics. Associations were estimated using logistic regression analysis and presented as unadjusted and adjusted odds ratios.
Prevalence rates of PSUI were no different between groups. However, significant difference in hyperglycemic groups worse scores for severe and very severe PSUI. When adjusted data for confound factors was compared with normoglycemic lean group, the hyperglycemic obese group had significantly higher odds for severe and very severe forms of UI using ICIQ-SF (aOR 3.157; 95% CI 1.308 to 7.263) and ISI (aOR 20.324; 95% CI 2.265 to 182.329) questionnaires and highest perceived impact of PSUI (aOR 4.449; 95% CI 1.591 to 12.442).
Our data indicate that obesity and hyperglycemia during pregnancy significantly increase the odds of severe forms and perceived impact of PSUI. Therefore, further effective preventive and curative treatments are greatly needed.
由于缺乏关于高血糖和肥胖对妊娠特异性尿失禁(PSUI)患病率影响的数据,我们使用经过验证的问卷和临床数据进行了一项横断面研究,以调查 PSUI 的患病率和特征。
这项横断面研究纳入了 2015 年至 2018 年期间在一家三级大学医院就诊的 539 名妊娠 34 周的女性。主要结局指标是 PSUI 的患病率、国际尿失禁咨询问卷简表(ICIQ-SF)和尿失禁严重程度指数(ISI)问卷。将女性分为四组:血糖正常的瘦型、血糖正常的肥胖型、高血糖的瘦型和高血糖的肥胖型。使用描述性统计对组间差异进行检验。使用逻辑回归分析估计关联,并以未调整和调整后的优势比呈现。
PSUI 的患病率在各组之间没有差异。然而,高血糖组严重和非常严重 PSUI 的评分较差。与血糖正常的瘦型组相比,调整混杂因素后的数据显示,高血糖肥胖组在使用 ICIQ-SF(aOR 3.157;95%CI 1.308 至 7.263)和 ISI(aOR 20.324;95%CI 2.265 至 182.329)问卷时有更高的严重和非常严重形式的 UI 的几率,以及更高的 PSUI 感知影响(aOR 4.449;95%CI 1.591 至 12.442)。
我们的数据表明,妊娠期间的肥胖和高血糖显著增加了严重形式和 PSUI 感知影响的几率。因此,需要进一步有效的预防和治疗措施。