经阴道分娩高龄初产妇产后早期盆腔器官脱垂发生的影响因素分析  

Influence factors analysis of early postpartum pelvic organ prolapse following transvaginal delivery in advanced maternal age primipara

作　　者：朱微波 李奇迅 孔令蕤 赵汉青 ZHU Weibo;LI Qixun;KONG Lingrui;ZHAO Hanqing(Department of Obstetrics and Gynecology,Beijing Tongren Hospital Mentougou Campus,Capital Medical University,Beijing 102300,China;College of Traditional Chinese Medicine,Hebei University,Baoding 071000,Hebei,China)

机构地区：[1]首都医科大学附属北京同仁医院门头沟医院妇产科,北京102300 [2]河北大学中医学院,河北保定071000

出　　处：《中国现代医生》2025年第3期32-35,117,共5页China Modern Doctor

摘　　要：目的探讨经阴道分娩高龄初产妇产后早期盆腔器官脱垂(pelvic organ prolapse,POP)发生的影响因素。方法回顾性选取2015年6月至2024年5月于首都医科大学附属北京同仁医院门头沟医院建档并经阴道分娩的153名高龄初产妇的临床基本资料和产后6周POP发生结局,根据产妇产后6周复查时是否发生盆腔器官脱垂分为非POP组(n=91)和POP组(n=62)。采用单因素差异性分析和多因素Logistic回归分析探讨影响产后早期POP发生的独立因素;按是否使用分娩球进行亚组分析,观察校正混杂因素后POP家族史与产后早期POP发生的关系。结果多因素Logistic回归分析显示新生儿出生体质量、产妇孕前体质量指数(body mass index,BMI)、是否使用分娩球和POP家族史是影响产后早期POP发生的独立因素(P<0.05)。在未使用分娩球的产妇中,采用Logistic回归校正新生儿出生体质量、孕前BMI和会阴裂伤前后,POP家族史对POP发生的影响均有统计学意义(P<0.05),而在使用分娩球的产妇中,无论是否校正,POP家族史对POP发生的影响均无统计学意义(P>0.05)。结论新生儿出生体质量、产妇孕前BMI和POP家族史是经阴道分娩高龄初产妇产后发生早期POP的危险因素,而使用分娩球是保护因素。同时针对有POP家族史的产妇,尽可能推荐其使用分娩球,可最大程度降低产后早期POP的发生风险。Objective To explore the influencing factors of early postpartum pelvic organ prolapse(POP)after vaginal delivery in advanced maternal age primipara.Methods Clinical data of 153 postpartum women were collected from Beijing Tongren Hospital Mentougou Campus,Capital Medical University,from June 2015 to May 2024.According to whether pelvic organ prolapse occurred during the 6-week postpartum reexamination of the primiparas,the parturients were divided into two groups:non-POP group(91 cases)and POP group(62 cases).Univariate and multivariate Logistic regression analyses were conducted to identify the independent factors influencing early postpartum POP.Subgroup analysis was also performed to assess the relationship between family history of POP and early postpartum POP after adjusting for confounding factors.Results Multivariate Logistic regression analysis revealed that neonatal birth weight,maternal pre-pregnancy body mass index(BMI),use of delivery balls,and family history of POP were independent factors associated with early postpartum POP occurrence(P<0.05).Among the parturients who did not use of delivery balls,before and after using Logistic regression to adjust for birth weight,pre-pregnancy BMI and perineal laceration,the impact of family history of POP on the occurrence of POP was statistically significant(P<0.05).However,among the parturients who used the delivery balls,regardless of whether the adjustment was made or not,the impact of family history of POP on the occurrence of POP was not statistically significant(P>0.05).Conclusion Neonatal birth weight,maternal pre-pregnancy BMI,and family history of POP are risk factors for early postpartum POP,while the use of delivery balls is a protective factor.Women with a family history of POP are advised to use delivery balls to reduce the risk of early postpartum POP.

关 键 词：高龄初产妇 盆腔器官脱垂 分娩球 影响因素 

分 类 号：R714.69[医药卫生—妇产科学]