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European Association of Urology Guidelines on the Diagnosis and Management of Female Non-neurogenic Lower Urinary Tract Symptoms. Part 1: Diagnostics, Overactive Bladder, Stress Urinary Incontinence, and Mixed Urinary Incontinence.欧洲泌尿外科学会女性非神经源性下尿路症状诊断与管理指南。第 1 部分:诊断、膀胱过度活动症、压力性尿失禁和混合性尿失禁。
Eur Urol. 2022 Jul;82(1):49-59. doi: 10.1016/j.eururo.2022.01.045. Epub 2022 Feb 23.
2
The role of obesity on urinary incontinence and anal incontinence in women: a review.肥胖对女性尿失禁和肛门失禁的作用:综述。
BJOG. 2022 Jan;129(1):162-170. doi: 10.1111/1471-0528.16848. Epub 2021 Sep 14.
3
Impact of prepregnancy body mass index on pregnancy outcomes, incidence of urinary incontinence and quality of life during pregnancy - An observational cohort study.孕前体重指数对妊娠结局、尿失禁发生率和妊娠期间生活质量的影响——一项观察性队列研究。
Biomed J. 2020 Dec;43(6):476-483. doi: 10.1016/j.bj.2019.11.001. Epub 2020 Nov 24.
4
Deleterious effects of gestational diabetes mellitus on the characteristics of the rectus abdominis muscle associated with pregnancy-specific urinary incontinence.妊娠糖尿病对与妊娠特异性尿失禁相关的腹直肌特征的不良影响。
Diabetes Res Clin Pract. 2020 Aug;166:108315. doi: 10.1016/j.diabres.2020.108315. Epub 2020 Jul 15.
5
Pregnancy-specific urinary incontinence in women with gestational hyperglycaemia worsens the occurrence and severity of urinary incontinence and quality of life over the first year post partum.患有妊娠期高血糖的女性的妊娠特异性尿失禁会在产后第一年加重尿失禁的发生率和严重程度以及生活质量。
Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:336-343. doi: 10.1016/j.ejogrb.2020.06.036. Epub 2020 Jun 27.
6
Alterations in the structural characteristics of rectus abdominis muscles caused by diabetes and pregnancy: A comparative study of the rat model and women.糖尿病和妊娠引起的腹直肌结构特征改变:大鼠模型与女性的比较研究。
PLoS One. 2020 Apr 3;15(4):e0231096. doi: 10.1371/journal.pone.0231096. eCollection 2020.
7
Altered maternal metabolism during mild gestational hyperglycemia as a predictor of adverse perinatal outcomes: A comprehensive analysis.轻孕期高血糖期间母体代谢改变作为不良围产结局预测因素的综合分析。
Biochim Biophys Acta Mol Basis Dis. 2020 Feb 1;1866(2):165478. doi: 10.1016/j.bbadis.2019.05.014. Epub 2019 May 30.
8
Overweight and obesity as major, modifiable risk factors for urinary incontinence in young to mid-aged women: a systematic review and meta-analysis.超重和肥胖是中青年女性尿失禁的主要可改变危险因素:系统评价和荟萃分析。
Obes Rev. 2018 Dec;19(12):1735-1745. doi: 10.1111/obr.12756. Epub 2018 Sep 19.
9
Prevalence of gestational diabetes and subsequent Type 2 diabetes among U.S. women.美国女性妊娠糖尿病及随后发生 2 型糖尿病的患病率。
Diabetes Res Clin Pract. 2018 Jul;141:200-208. doi: 10.1016/j.diabres.2018.05.010. Epub 2018 May 26.
10
Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, type, and risk factors.未生育女性孕前及孕期尿失禁:患病率、发病率、类型及危险因素
Int Urogynecol J. 2018 Mar;29(3):353-362. doi: 10.1007/s00192-018-3554-1. Epub 2018 Jan 23.

肥胖和高血糖对妊娠特异性尿失禁的影响。

Impact of Obesity and Hyperglycemia on Pregnancy-specific Urinary Incontinence.

机构信息

Perinatal Diabetes Research Center, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, SP, Brazil.

Department of Health Sciences, Universidade Sagrado Coração, Bauru, São Paulo, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2023 Jun;45(6):303-311. doi: 10.1055/s-0043-1770087. Epub 2023 Jul 21.

DOI:10.1055/s-0043-1770087
PMID:37494572
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10411106/
Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。