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初产妇产后六个月阴道松弛的患病率。

Prevalence of vaginal laxity in primiparous women six months after birth.

作者信息

Godoy Marina Resende, Pereira Gláucia Miranda Varella, Viegas Clara Vale, Monteiro Marilene Vale de Castro

机构信息

Universidade Federal de Minas Gerais Faculdade de Medicina Departamento de Ginecologia e Obstetrícia Belo HorizonteMG Brazil Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Universidade de Campinas Faculdade de Ciências Médicas Departamento de Ginecologia e Obstetrícia CampinasSP Brazil Departamento de Ginecologia e Obstetrícia, Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, SP, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2025 Jul 15;47. doi: 10.61622/rbgo/2025rbgo61. eCollection 2025.

Abstract

OBJECTIVE

To assess the prevalence of VL in primiparous women undergoing vaginal birth or caesarean section; and its association with obstetric, urinary, intestinal and sexual factors for its occurrence.

METHODS

This is a cross-sectional study carried out between July 2021 and January 2023. Primiparous women who underwent vaginal birth or caesarean section without complaints of VL during pregnancy were included. Clinical and obstetric data were collected and participants completed questionnaires on the impact of urinary incontinence (ICIQ-SF), vaginal symptoms (ICIQ-VS) and sexual distress (FSDS-R) at recruitment and six-months postpartum. Univariate and multivariate logistic regression was performed, considering VL as the outcome and p=0.05.

RESULTS

One hundred participants were included for data analysis. The prevalence of VL was 8%. In the univariate analysis, SUI, urgency urinary incontinence (UUI), coital incontinence, constipation and the ICIQ-VS and ICIQ-SF scores were associated with VL. The ICIQ-VS, FSDS-R and ICIQ-SF scores increased the risk of VL by one-fold. However, only UUI (OR 10.50(CI 95% 1.90-58.10), coital incontinence (OR 42.00(CI 95% 3.11-566.38), and ICIQ-VS (vaginal symptoms OR 1.32(CI 95% 1.05-1.66) and ICIQ-SF (OR 1.25(CI 95% 1.02-1.54), scores remained associated with VL in multivariate-analysis.

CONCLUSION

The prevalence of VL in primiparous women was lower than that reported in other studies and showed an association with the occurrence of vaginal symptoms, UUI and coital incontinence, six- months postpartum.

摘要

目的

评估经阴道分娩或剖宫产的初产妇中阴道松弛(VL)的患病率;以及其与发生VL的产科、泌尿、肠道和性因素之间的关联。

方法

这是一项于2021年7月至2023年1月期间开展的横断面研究。纳入在孕期无阴道松弛主诉且经阴道分娩或剖宫产的初产妇。收集临床和产科数据,参与者在入组时及产后6个月完成关于尿失禁影响(ICIQ-SF)、阴道症状(ICIQ-VS)和性困扰(FSDS-R)的问卷调查。进行单因素和多因素逻辑回归分析,将阴道松弛作为结果变量,设定p = 0.05。

结果

100名参与者纳入数据分析。阴道松弛的患病率为8%。在单因素分析中,压力性尿失禁(SUI)、急迫性尿失禁(UUI)、性交性尿失禁、便秘以及ICIQ-VS和ICIQ-SF评分与阴道松弛相关。ICIQ-VS、FSDS-R和ICIQ-SF评分使阴道松弛风险增加一倍。然而,在多因素分析中,只有UUI(比值比10.50(95%置信区间1.90 - 58.10))、性交性尿失禁(比值比42.00(95%置信区间3.11 - 566.38))以及ICIQ-VS(阴道症状比值比1.32(95%置信区间1.05 - 1.66))和ICIQ-SF(比值比1.25(95%置信区间1.02 - 1.54))评分仍与阴道松弛相关。

结论

初产妇中阴道松弛的患病率低于其他研究报道,且与产后6个月时阴道症状、UUI和性交性尿失禁的发生有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00f4/12266853/59ce105876b5/1806-9339-rbgo-47-e-rbgo61-gf01.jpg

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