Miyamoto Keisuke, Komatsu Hiroaki, Nagata Hiroki, Nagira Kei, Motomura Eri, Shimizu Natsuko, Tanaka Ayumi
Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Japan.
Department of Obstetrics and Gynecology, Asagiri Hospital, Akashi, Japan.
J Obstet Gynaecol Res. 2024 Mar;50(3):424-429. doi: 10.1111/jog.15867. Epub 2023 Dec 20.
To determine the postpartum urinary retention rate and risk factors after delivery using epidural analgesia.
This single-center retrospective study targeted 341 women who gave birth after at least 37 weeks of gestation from April to August 2021; from this cohort, 208 patients were examined. The postpartum urinary retention rate was compared between the no epidural analgesia group (n = 107) and epidural analgesia group (n = 101). Subsequently, risk factors for postpartum urinary retention were investigated in the epidural analgesia group.
After adjustment by propensity score matching for age, body mass index, being primiparous, and labor induction as covariates, the analysis of the incidence of postpartum urinary retention revealed that the epidural analgesia group exhibited a significantly higher postpartum urinary retention rate than the no epidural analgesia group (30% vs. 11%, p = 0.02). The investigation results regarding risk factors for postpartum urinary retention in the epidural analgesia group obtained through a univariate analysis showed that being primiparous and having a prolonged second stage of labor were significantly correlated with postpartum urinary retention. Multivariate analysis indicated that a prolonged second stage of labor was an independent risk factor for postpartum urinary retention (p = 0.03; odds ratio: 3.18; 95% confidence interval: 1.08-9.77). All patients recovered from postpartum urinary retention by day 4.
The postpartum urinary retention rate after delivery using epidural analgesia was 25.7%. In the case of epidural analgesia deliveries, a prolonged second stage of labor was an independent risk factor for postpartum urinary retention.
确定分娩后使用硬膜外镇痛的产后尿潴留发生率及危险因素。
本单中心回顾性研究纳入了2021年4月至8月妊娠至少37周后分娩的341名女性；从该队列中选取208例患者进行检查。比较无硬膜外镇痛组（n = 107）和硬膜外镇痛组（n = 101）的产后尿潴留发生率。随后，对硬膜外镇痛组产后尿潴留的危险因素进行调查。
在将年龄、体重指数、初产情况和引产作为协变量进行倾向评分匹配调整后，对产后尿潴留发生率的分析显示，硬膜外镇痛组的产后尿潴留发生率显著高于无硬膜外镇痛组（30%对11%，p = 0.02）。通过单因素分析得出的硬膜外镇痛组产后尿潴留危险因素的调查结果显示，初产和第二产程延长与产后尿潴留显著相关。多因素分析表明，第二产程延长是产后尿潴留的独立危险因素（p = 0.03；比值比：3.18；95%置信区间：1.08 - 9.77）。所有患者在第4天从产后尿潴留中恢复。
分娩后使用硬膜外镇痛的产后尿潴留发生率为25.7%。在硬膜外镇痛分娩的情况下，第二产程延长是产后尿潴留的独立危险因素。
