|
|
|
| Relationship between maternal body mass,neonatal weight and pelvic floor dysfunction |
| SUN Jian XIA Zhi-jun▲ |
| Department of Obstetrics and Gynecology,Shengjing Hospital Affiliated to China Medical University,Liaoning Province,Shenyang 110004,China |
|
|
|
|
Abstract Objective To analyze the influencing factors of pelvic floor dysfunction,and to compare the influence of different levels of body mass index(BMI)of maternal pre-pregnancy,antenatal and neonatal weight on pelvic floor function.Methods The clinical data of 210 full-term postpartum women who underwent pelvic floor function examination in Shengjing Hospital Affiliated to China Medical University from July 2019 to January 2020 were collected and analyzed.Pelvic floor condition,muscle strength,prolapse and stress urinary incontinence were recorded.Multivariate analysis was performed on 100 patients who were followed up for 3 times after delivery,and their pelvic floor muscle strength was assessed at 3 and 6 months postpartum.Results Prenatal BMI,weight gain,fetal weight and birth mode had significant influence on pelvic floor muscle,there were no significant influence in the influence of birth mode and age on pelvic floor muscle(P＞0.05).Dynamic pressure,type Ⅰmuscle strength and type Ⅱmuscle strength were used as dependent variables,and the factors with significance less than 0.1 in univariate analysis were used as independent variables for multivariate regression analysis,the results showed that birth mode had a significant impact on dynamic stress,neonatal weight had a negative impact on type Ⅰmuscle strength,and prenatal BMI had a significant negative impact on type Ⅰand Ⅱmuscle strength(P＜0.05).In univariate analysis,the comparison of pelvic floor muscle function in each group showed that the influence of birth style on urinary leakage was statistically significant(χ2=1.997,P=0.048).With urinary leakage as the dependent variable,univariate analysis showed that the factors with significance ＜0.1(pre pregnancy BMI,prenatal BMI,birth style)were used as independent variables for regression analysis,the results showed that the birth mode was not the same(β=0.151,P=0.029).In univariate analysis,the influence of weight gain,fetal weight and birth mode on pelvic floor muscle function were statistically significant,and electrical stimulation therapy had a significant positive effect(P＜0.05).The dynamic pressure and type Ⅰmuscle strength of the patients who were reexamined 3 months after delivery were taken as dependent variables,and the factors with significance less than 0.1 in univariate analysis were taken as independent variables for multivariate regression analysis,the results showed that birth mode and treatment had significant effects on dynamic pressure and type Ⅰmuscle strength at 3 months postpartum(P＜0.05).The dynamic pressure,class Ⅰmuscle strength and class Ⅱmuscle strength of the patients who were reexamined 6 months after delivery were taken as dependent variables,and the factors with significance less than 0.1 in univariate analysis were taken as independent variables for multivariate regression analysis,the results showed that neonatal weight and prenatal BMI had significant negative influence on pelvic floor muscle strength,and treatment could effectively improve the fast and slow muscle fiber strength.Conclusion Prenatal BMI,weight gain during pregnancy,neonatal weight and birth mode have significant influence on pelvic floor dysfunction.
|
|
|
|
|
|
| [16] |
郭华峰，杨俊娟，张新华，等.不同分娩方式产妇产后早期盆底功能影响因素分析[J].郑州大学学报（医学版），2020，55（1）：123-126.
|
| [17] |
徐杰，常凤玲，秦金霞.妊娠与不同分娩方式盆底结构超声影像差异及临床意义[J].现代医药卫生，2017，33（9）：1378-1380.
|
| [18] |
陶波，蔡文莲.3600 例产后妇女盆底肌电检测结果分析[J].中国现代医学杂志，2018，28（11）：117-120.
|
| [19] |
康建萍，沈霞，耿茂林，等.雌、孕激素相关受体表达和松弛素水平与妊娠晚期压力性尿失禁相关性研究[J].中国妇幼保健，2016，31（11）：2285-2287.
|
| [20] |
Radzimińska A，Strnczyńska A，Weber-Rajek M，et al.The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence：a systematic literature review[J].Clin Interv Aging，2018，17（13）：957-965.
|
| [21] |
Yang SM，Sang WS，Feng J，et al.The effect of rehabilitation exercises combined with direct vagina low voltage low frequency electric stimulation on pelvic nerve electrophysiology and tissue function in primiparous women：a randomised controlled trial[J].J Clin Nurs，2017，26（23-24）：4537-4547.
|
| [22] |
魏涛，王德慧，王少为，等.不同分娩方式产妇盆底肌电分布及相关因素分析[J].中国医刊，2019，54（5）：532-535.
|
| [1] |
Louis-Charles K，Biggie K，WolfinbargerA，et al.Pelvic floor dysfunction in the female athlete[J].Curr Sports Med Rep，2019，18（2）：49-52.
|
| [2] |
朱兰，孙智晶.女性压力性尿失禁诊断和治疗指南（2017）[J].中华妇产科杂志，2017，52（5）：289-293.
|
| [3] |
李明明.阴道分娩与剖宫产对孕产妇产后压力性尿失禁的影响及早期康复锻炼效果[J].中国妇幼保健，2018，33（20）：4614-4616.
|
| [4] |
王凤珍，张虹霞.盆底神经肌肉刺激治疗仪用于产后盆底功能恢复作用的分析[J].齐齐哈尔医学院学报，2010，31（20）：3248.
|
| [6] |
穆靓，刘莉，韦爱华，等.经会阴动态三维超声对便秘的产后女性盆底解剖结构重塑的观察[J].中国临床解剖学杂志，2017，35（6）：633-636.
|
| [5] |
Persu C，Chapple CR，Cauni V，et al.Pelvic organ prolapse quantification system（POP-Q）-a new era in pelvic prolapse staging[J].J Med Life，2011，4（1）：75-81.
|
| [7] |
Zhao R，Xu L，Wu ML，et al.Maternal pre-pregnancy body mass index，gestational weight gain influence birth weight[J].Women Birth，2018，31（1）：e20-e25.
|
| [8] |
Lee UJ，Kerkhof MH，van Leijsen SA，et al.Obesity and pelvic organ prolapse[J].Curr Opin Urol，2017，27（5）：428-434.
|
| [9] |
Magnani PS，Bettiol H，Da Silva A.Urinary incontinence between 12 and 24 months postpartum：a cross-sectional study nested in a Brazilian cohort from two cities with different socioeconomic characteristics[J].Int Urogynecol J，2019，30（6）：1003-1011.
|
| [10] |
张康，武卉，黄赛琼，等.不同分娩方式对产后早期盆底功能的影响[J].解放军医学院学报，2018，39（9）：760-764.
|
| [11] |
Lamerton TJ，Torquati L，Brown WJ.Overweight and obesity as major，modifiable risk factors for urinary incontinence in young to mid-aged women：a systematic review and Meta-analysis[J].Obes Rev，2018，19（12）：1735-1745.
|
| [12] |
吴琳琳，雷琼，段冬梅，等.妊娠期代谢性综合征：一个值得探讨的科学问题[J].中国实用妇科与产科杂志，2018，34（9）：989-993.
|
| [13] |
李晓红，陈莉莉.孕前及孕期母体体重指数与妊娠期糖尿病及巨大儿的关系[J].中国妇幼保健，2017，9，32（17）：4073-4075.
|
| [14] |
赵娜，蒋小芒.会阴侧切以及自然裂伤对初产妇第二产程、产后性功能、盆底肌力和肌电位的影响[J].中国妇产科临床杂志，2018，19（5）：457-458.
|
| [15] |
Castro-Pardinas MA，Torres-Lacomba M，Navarro-Brazález B.Muscle function of the pelvic floor in healthy，puerperal women and with pelvic floor dysfunction[J].Actas Urol Esp，2017，41（4）：249-257.
|
|
|
|
