Department of Nursing, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China.
School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu Province, China.
PLoS One. 2024 Oct 3;19(10):e0308563. doi: 10.1371/journal.pone.0308563. eCollection 2024.
Pelvic floor dysfunction (PFD) is a disease of weakened pelvic floor support tissues, leading to changes in the pelvic organ position and function of pelvic organs, with long-term effects on women. This study aimed to assess pelvic floor function using electrophysiology and clinical symptoms, exploring the risk factors for PFD one month postpartum.
This cross-sectional study included 845 women from postpartum outpatient clinic of Nantong Affiliated Hospital from August 2019 to October 2021. Pelvic floor muscle strength was evaluated via pelvic floor surface electromyography. Clinical symptoms (urinary incontinence (UI) and pelvic organ prolapse) were diagnosed by gynecologists. Sociodemographic, pregnancy, and obstetrical data were obtained from self-reported questionnaires and electronic records.
The study identified maternal age, parity, immigrant status, and economic income as factors were related to PFD. Gestational constipation increased the risk of abnormal resting muscle strength (OR:1.553, 95%CI: 1.022-2.359). Cesarean delivery was associated with higher rates of abnormal resting muscle strength than vaginal delivery (post-resting stage: OR, 2.712; 95% CI, 1.189-6.185), but a decreased incidence of UI (OR: 0.302; 95% CI, 0.117-0.782). Increased gestational weight gain was correlated with a greater risk of developing UI (OR:1.030, 95%CI: 1.002-1.058). Women with vaginal inflammation faced a higher risk of abnormal fast-twitch muscle (OR: 2.311, 95%CI: 1.125-4.748).
In addition to uncontrollable factors like mode of delivery, age, and parity, interventions targeting weight gain and constipation during pregnancy and vaginal flora could mitigate the risks of PFD. Educational programs for pregnant women should emphasize a proper diet and lifestyle. For women with vaginal inflammation, clinical treatment should be carried out as soon as possible to avoid further aggravating the damage to the pelvic floor muscles.
盆底功能障碍（PFD）是一种盆底支持组织薄弱的疾病，导致盆腔器官位置和功能改变，对女性产生长期影响。本研究旨在通过电生理学和临床症状评估盆底功能，探讨产后 1 个月发生 PFD 的危险因素。
本横断面研究纳入了 2019 年 8 月至 2021 年 10 月南通附属医院产后门诊的 845 名女性。通过盆底表面肌电图评估盆底肌力量。由妇科医生诊断临床症状（尿失禁（UI）和盆腔器官脱垂）。社会人口学、妊娠和产科数据来自自我报告的问卷和电子记录。
本研究发现产妇年龄、产次、移民身份和经济收入是与 PFD 相关的因素。妊娠期便秘增加异常静息肌力量的风险（OR：1.553，95%CI：1.022-2.359）。剖宫产与阴道分娩相比，异常静息肌力量的发生率更高（静息后阶段：OR，2.712；95%CI，1.189-6.185），但 UI 的发生率更低（OR：0.302；95%CI，0.117-0.782）。妊娠期体重增加与发生 UI 的风险增加相关（OR：1.030，95%CI：1.002-1.058）。阴道炎症的女性发生异常快肌的风险更高（OR：2.311，95%CI：1.125-4.748）。
除了分娩方式、年龄和产次等不可控因素外，针对妊娠期间体重增加和便秘以及阴道菌群的干预措施可以降低 PFD 的风险。应向孕妇开展教育计划，强调适当的饮食和生活方式。对于患有阴道炎症的女性，应尽快进行临床治疗，避免进一步加重盆底肌肉损伤。
