de Amorim Amanda Cruz, Roque Luana Caran, Ito Letícia Miyuki, de Oliveira Murer Pietra Giulia, Sartori Marair Gracio Ferreira
Gynecology Department of Escola Paulista de Medicina (EPM) from the Federal, University of São Paulo Rua Napoleão de Barros, São Paulo, SP, 608, Brazil.
BMC Pregnancy Childbirth. 2025 Jul 10;25(1):742. doi: 10.1186/s12884-024-07071-0.
Monitoring Pelvic Floor Dysfunction (PFD) symptoms during pregnancy is crucial to treating and preventing the onset or worsening of dysfunctions in the postpartum period. This study aimed to evaluate PFD symptoms over time in pregnant and postpartum women.
This longitudinal follow-up study involved pregnant and postpartum women. PFD symptoms were assessed using an obstetric history questionnaire and the Australian Pelvic Floor Questionnaire (APFQ). Pregnant women were grouped into two periods: up to 28 weeks (Period 1) and from 28 to 40 weeks of gestation (Period 2). Postpartum women were divided into three periods: up to 6 weeks (Period 3), between 7 and 24 weeks (Period 4), and more than 24 weeks postpartum (Period 5).
A total of 46 and 44 pregnant women and 65, 53, and 39 postpartum women were analyzed in Periods 1 to 5, respectively. For pregnant women, non-parametric ANOVA revealed a significant difference (p = 0.02) in sexual function between Periods 1 (2.1 ± 2.8) and 2 (1.1 ± 1.8). Among postpartum women, urinary function improved significantly across Periods 3 (9.5 ± 5.9), 4 (4.0 ± 5.1), and 5 (5.7 ± 5.3; p < 0.001). Sexual function deteriorated significantly across these periods. Spearman's correlation indicated moderate associations between urinary function and pregnancy (p < 0.001, r = 0.4) and between prolapse and parity (p = 0.02, r = 0.35) for pregnant women. For postpartum women, moderate correlations were observed between urinary function and parity (p = 0.02, r = 0.3), bowel function and age (p = 0.04, r=-0.29), and sexual function and age (p = 0.049, r=-0.3).
The study highlights variations in PFD occurrence during pregnancy and the postpartum period, particularly concerning urinary and sexual function.
孕期监测盆底功能障碍（PFD）症状对于治疗和预防产后功能障碍的发生或恶化至关重要。本研究旨在评估孕妇和产后女性不同时期的PFD症状。
这项纵向随访研究纳入了孕妇和产后女性。使用产科病史问卷和澳大利亚盆底问卷（APFQ）评估PFD症状。孕妇分为两个时期：妊娠28周及以内（第1期）和妊娠28至40周（第2期）。产后女性分为三个时期：产后6周及以内（第3期）、产后7至24周（第4期）和产后24周以上（第5期）。
第1至5期分别分析了46名和44名孕妇以及65名、53名和39名产后女性。对于孕妇，非参数方差分析显示第1期（2.1±2.8）和第2期（1.1±1.8）之间性功能存在显著差异（p = 0.02）。在产后女性中，第3期（9.5±5.9）、第4期（4.0±5.1）和第5期（5.7±5.3；p < 0.001）的排尿功能显著改善。这些时期性功能显著恶化。Spearman相关性分析表明，孕妇的排尿功能与妊娠之间存在中度关联（p < 0.001，r = 0.4），脱垂与产次之间存在中度关联（p = 0.02，r = 0.35）。对于产后女性，排尿功能与产次之间（p = 0.02，r = 0.3）、排便功能与年龄之间（p = 0.04，r = -0.29）以及性功能与年龄之间（p = 0.049，r = -0.3）观察到中度相关性。
该研究突出了孕期和产后PFD发生率的变化，特别是在排尿和性功能方面。
