初次妊娠分娩方式对再次妊娠期间压力性尿失禁发生率的影响

目的 研究第1次妊娠剖宫产分娩能否降低第2次妊娠期间压力性尿失禁(SUI)的发生率.方法 选取足月分娩的246例经产妇为研究对象,年龄20～35岁,既往足月分娩1次,2次分娩新生儿出生体质量在2 500～4 000 g,2次分娩间隔时间≤5年,无妊娠并发症；其中第1次妊娠分娩方式为阴道分娩者128例(阴道分娩组),剖宫产分娩者118例(剖宫产分娩组).第2次妊娠分娩后2周内电话随访2次足月妊娠期间SUI情况,比较第1次阴道分娩与剖宫产分娩妇女妊娠期尿失禁的发病情况.结果 剖宫产分娩组的妇女第2次妊娠期SUI的发病率为40.7％,高于阴道分娩组的发病率(36.7％),但差异无统计学意义(P＞0.05).将孕妇年龄、体质量、分娩孕周、两次分娩间隔时间和第1次分娩方式等因素进行多元逻辑回归分析,第1次妊娠的分娩方式与第2次妊娠期间SUI的发病无相关性(P＞0.05).结论 第1次妊娠剖宫产分娩对再次妊娠后的妊娠期SUI的发病无明显保护作用.

Impact of different ways of first delivery on incidence of stress urinary incontinence during subsequent pregnancy

Objective To evaluate whether Cesarean for the first pregnancy can lower the incidence of stress urinary incontinence(SUI) during the second pregnancy.Methods Two hundred and forty-six pregnant multiparas aged between 20 to 35 years who had one term of delivery were selected.The weight of newborn infants was 2 500 to 4 000 g.The duration between two pregnancy was no more than five years.There was no pregnancy-related complications.These women were divided into vaginal delivery group(gave birth to the first child through vagina,n=128) and cesarean group(terminated the first term of pregnancy by cesarean,n=118).All of them were followed up by telephone two weeks after the second delivery,the incidences of SUI during two terms of pregnancy were obtained,and the incidences of SUI were compared between two groups.Results The incidence of SUI during the second term of pregnancy in cesarean group was 40.7%,which was higher than that in vaginal delivery group(36.7%),and there was no significant difference between two groups(P>0.05).Multiple Logistic regression analysis of age,body weight,gestation week at delivery,time from the first delivery and way of first delivery indicated that there was no correlation of way of first delivery with incidence of SUI during the second term of pregnancy(P>0.05).Conclusion Cesarean has no protective effect on SUI during the subsequent pregnancy.