35岁及以上产妇产后盆底失弛缓综合征发生现况及影响因素分析

目的分析≥35岁(高龄)产妇产后盆底失弛缓综合征(SPFS)发生现况及其影响因素。方法以2018年12月至2020年5月在北京市大兴区人民医院分娩并于产后6~8周行盆底筛查的高龄产妇为调查对象,采用问卷调查法收集研究对象基本信息、孕期及分娩相关资料,采用单因素、多因素方法分析产后SPFS发生的影响因素。结果500名高龄产妇平均年龄(39.84±2.50)岁,产次1~4次,平均(2.16±1.04)次。高龄产妇产后SPFS发生率为20.60%。多因素分析结果显示,阴道分娩(OR=3.842)、有便秘史(OR=3.271)、滥用泻药(OR=3.656)、第二产程时间≥2 h(OR=6.052)、局部炎症(OR=2.319)、孕期体重增加≥20 kg(OR=4.676)、有焦虑情绪(OR=5.658)是SPFS发生的危险因素,而盆底功能锻炼(OR=0.242)是保护因素。结论高龄产妇产后发生SPFS风险较高,影响因素较多,需引起医务工作者及个人重视,可采取针对性措施干预导致SPFS发生的影响因素。

Status and influencing factors of spastic pelvic floor syndrome in parturient aged 35 years and over

Objective To analyze the status and influencing factors of spastic pelvic floor syndrome （SPFS） in elderly parturient. Methods From December 2018 to May 2020, the elderly parturient who gave birth in Beijing Daxing District People's Hospital and underwent pelvic floor screening 6-8 weeks after delivery were investigated. The basic information, pregnancy and delivery related data of the subjects were collected by questionnaire survey. The influencing factors of postpartum SPFS were analyzed by univariate and multivariate analysis methods. Results The average age of 500 elderly parturient was （39.84±2.50） years, and the parity was 1 to 4 times, with an average of （2.16±1.04） times. The incidence rate of postpartum SPFS in elderly parturient was 20.60%. The results of multivariate analysis showed that vaginal delivery （OR=3.842）, history of constipation （OR=3.271）, abuse of laxatives （OR=3.656）, second stage of labor ≥2 h （OR=6.052）, local inflammation （OR=2.319）, weight gain during pregnancy ≥20 kg （OR=4.676）, and anxiety （OR=5.658） were risk factors for SPFS, while pelvic floor function exercise （OR=0.242） was a protective factor. Conclusions The risk of postpartum SPFS in elderly parturient is higher, and there are many influencing factors, which need to attract the attention of medical workers and individuals. Targeted measures can be taken to intervene the influencing factors leading to SPFS.