出生方式与产后盆地疾病的关联
Joan L Blomquist1, Alvaro Muñoz2, Megan Carroll2
1Department of Gynecology, Greater Baltimore Medical Center, Maryland.
JAMA
|December 19, 2018
概括
与阴道分娩相比,剖腹产减少了盆地疾病的风险,如尿失禁. 手术性阴道分娩会增加门失禁和骨盆器官倒退的风险.
科学领域:
- 产科和妇科
- 骨盆健康研究
背景情况:
- 盆地疾病 (PFD) 影响约25%的美国妇女,与分娩有关.
- 在分娩后的长期进展情况尚不清楚.
研究的目的:
- 为了确定产后PFD的发病率.
- 确定与产后1至2十年内PFD发展相关的孕产妇和产科因素.
主要方法:
- 一项前性队列研究对1528名妇女进行了长达9年的跟踪.
- 参与者根据分娩方式进行分类:剖腹产,自发性阴道或手术性阴道分娩.
- 每年评估骨盆底疾病,包括压力尿失禁 (SUI),膀过活 (OAB),门尿失禁 (AI) 和骨盆器官脱落 (POP).
主要成果:
- 在5. 1年的中位随访期内,估计累计发生15年.
- 与自发性阴道分娩相比,剖腹产对SUI,OAB和POP的危险性明显较低.
- 手术性阴道分娩与AI和POP的显著更高的风险有关. 更大的生殖器间隙大小独立地增加了POP风险.
结论:
- 与自发性阴道分娩相比,剖腹产似乎可以防止SUI,OAB和POP的发展.
- 手术性阴道分娩增加了AI和POP的风险.
- 生殖器间隙的大小是POP的一个重要风险因素,不论传递方式如何.
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