初产妇产后发生性功能障碍的影响因素及其列线图风险模型的构建  

Influencing factors of postartum female sexual dysfunction in primiparas and construction of its nomogram risk model

作　　者：赵园园 雷刘燕 张恩悦 ZHAO Yuanyuan;LEI Liuyan;ZHANG Enyue(Department of Obstetrics and Gynecology,Lishu Central Hospital,Lishui 323000,Zhejiang,China)

机构地区：[1]丽水市中心医院妇产科,浙江丽水323000

出　　处：《中国性科学》2021年第11期74-77,共4页Chinese Journal of Human Sexuality

摘　　要：目的观察初产妇产后性功能障碍(PFSD)的影响因素,并构建列线图风险模型。方法选取2020年1月至2021年1月在丽水市中心医院分娩的99例初产妇作为研究对象。收集产妇资料,根据产妇产后8周PFSD发生情况,将产妇分为PFSD组(n=63)及未发生PFSD组(n=36),采用Logistic回归分析检验初产妇PFSD发生的危险因素,探讨列线图风险模型对初产妇PFSD发生风险的预测价值。结果 99例初产妇中,有63例发生PFSD,有36例未发生PFSD;初步比较PFSD组与未发生PFSD组基线资料后,经Logistic回归分析结果显示,年龄高、阴道分娩、母乳喂养、配偶不参与家务、产后<6周开始性生活、合并产后抑郁症、催乳激素(PRL)水平高等是产后PFSD发生的风险因子(OR>1,P<0.05);使用Bootstrap内部验证法对PFSD发生的列线图风险模型进行验证,校准曲线几乎和Y=X直线重合,模型校准度良好;并对列线图风险模型进行验证,绘制受试者工作特征(ROC)曲线发现,列线图风险模型预测初产妇PFSD发生风险的曲线下面积(AUC)>0.80,有一定预测价值。结论初产妇发生PFSD的风险较高,与多项因素密切相关,构建列线图风险模型具有良好的区分度和精准度,并有较好的预测效能。Objective To observe the influencing factors of postartum female sexual dysfunction(PFSD) in primiparas, and construct its nomogram risk model. Methods 99 primiparas who gave birth in Lishui Central Hospital from January 2020 to January 2021 were selected as the research objects. Puerpera data were collected and divided into PFSD group(n=63) and non-PFSD group(n=36) according to the incidence of PFSD at 8 weeks postpartum. Logistic regression analysis was used to examine the risk factors of PFSD in primiparas, and to explore the predictive value of the risk model for the incidence of PFSD in primiparas. Results Among 99 primiparas, 63 had PFSD and 36 did not. After a preliminary comparison of the baseline data between the PFSD group and the non-PFSD group, Logistic regression analysis showed that high age, vaginal delivery, breastfeeding, spouse′s non-involvement in housework, sexual intercourse < 6 weeks after delivery, combined with postpartum depression, and high level of prolactin hormone(PRL) were the risk factors for postpartum PFSD(OR>1, P<0.05);Bootstrap internal verification method was used to verify the nomogram risk model of PFSD. The calibration curve almost coincided with the Y=X line, and the calibration degree of the model was good. The area under the curve(AUC) for predicting the risk of PFSD in primiparas was more than 0.80, which had certain predictive value. Conclusions The risk of PFSD in primiparas is high, which is closely related to many factors, the nomogram risk model has good discrimination and accuracy, and has good prediction performance.

关 键 词：性功能障碍 初产妇 年龄 喂养 抑郁症 催乳激素 

分 类 号：R714[医药卫生—妇产科学]