Pelvic floor function is independently associated with pelvic organ prolapse
Pelvic floor function is independently associated with pelvic organ prolapse
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DOI：
10.1111/j.1471-0528.2009.02379.x
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发表时间：
2009-12-01
影响因子：
5.8
通讯作者：
Bo, K.
中科院分区：
文献类型：
--
作者：
Braekken, I. H.;Majida, M.;Bo, K.
目的探讨盆腔器官脱垂（POP）的危险因素，包括体力活动、临床测量的关节活动度和盆底肌肉（PFM）功能。设计一对一年龄和产次匹配的病例对照研究。地点在挪威Akershus大学医院和一家门诊理疗诊所。人群49例POP妇女（持久性有机污染物定量，阶段>= II）和49项对照（0和I期）从社区妇科医生和报纸广告中招募。包括Beighton评分系统（关节过度活动）和阴道压力传感器测量（PFM功能）。采用一对一配对病例对照研究的单变量和多变量条件logistic回归分析，并报告比值比和95%CI。主要结局指标盆底肌肉功能（力量、耐力和静息压力）、社会经济状况、体重指数、重职业工作、体力活动、家族史、产科因素和结缔组织虚弱标志物（条纹，静脉曲张，瘀伤，腹直肌痉挛，关节过度活动）。结果没有显着差异，发现组之间的绝经后状态，目前的吸烟，目前的低强度运动，出生类型（剖腹产，钳，真空），出生体重，存在的条纹，腹直肌痉挛和关节过度活动。体重指数（OR 5.0; 95% CI 1.1-23.0），社会经济状况（OR 10.5; 95% CI 2.2-50.1），重职业工作（OR 9.6; 95% CI 1.3-70.3），肛门括约肌撕裂（OR 4.5; 95% CI 1.0-20.0），PFM强度（OR 7.5; 95% CI 1.5-36.4）和耐力（或11.5; 95%CI 2.0-66.9）与POP独立相关。肛门括约肌撕裂和PFM功能与POP独立相关，而关节活动和体力活动则无关。
ObjectiveTo investigate the risk factors for pelvic organ prolapse (POP), including physical activity, clinically measured joint mobility and pelvic floor muscle (PFM) function.DesignOne-to-one age- and parity-matched case-control study.SettingAkershus university hospital and one outpatient physiotherapy clinic in Norway.PopulationForty-nine women with POP (POP quantification, stage >= II) and 49 controls (stages 0 and I) were recruited from community gynaecologists and advertisements in newspapers.MethodsValidated questionnaires, interview and clinical examination, including Beighton's scoring system (joint hypermobility) and vaginal pressure transducer measurements (PFM function), were used. Univariate and multivariate conditional logistic regression analyses for one-to-one matched case-control studies were used, and odds ratios with 95% CIs are reported.Main outcome measuresPelvic floor muscle function (strength, endurance and resting pressure), socioeconomic status, body mass index, heavy occupational work, physical activity, family history, obstetric factors and markers of connective tissue weakness (striae, varicose veins, bruising, diastasis recti abdominis, joint hypermobility).ResultsNo significant differences were found between groups with regard to postmenopausal status, current smoking, current low-intensity exercise, type of birth (caesarean, forceps, vacuum), birth weight, presence of striae, diastasis recti abdominis and joint hypermobility. Body mass index (OR 5.0; 95% CI 1.1-23.0), socioeconomic status (OR 10.5; 95% CI 2.2-50.1), heavy occupational work (OR 9.6; 95% CI 1.3-70.3), anal sphincter lacerations (OR 4.5; 95% CI 1.0-20.0), PFM strength (OR 7.5; 95% CI 1.5-36.4) and endurance (OR 11.5; 95% CI 2.0-66.9) were independently related to POP.ConclusionsBody mass index, socioeconomic status, heavy occupational work, anal sphincter lacerations and PFM function were independently associated with POP, whereas joint mobility and physical activity were not.