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目的探讨生育相关因素及体质指数(BMI)对盆腔器官脱垂(POP)的影响,为POP的防治提供科学依据。方法采用分层整群随机抽样的方式,于2014年4月-2015年8月在甘肃省辖区内抽取9 605例女性为调查对象,以非条件Logistic回归模型分析生育相关因素及BMI与女性POP的相关性。结果与单产次相比,分娩2次的女性患POP的风险性为1.61倍(OR=1.61,95%CI:1.39~1.88),分娩3次及其以上的女性患POP的风险性为1.50倍(OR=1.50,95%CI:1.27~1.77),按POP严重程度分组后,重度POP的患病风险随产次的增加而增加(χ_(趋势)~2=47.63,P<0.01);与有剖宫产史的体重正常女性相比,有助产史且BMI≥24 kg/m2的女性患POP的风险最大(OR=4.59,95%CI:1.91~11.04),与BMI正常且分娩正常体重儿的女性相比,分娩巨大儿且BMI≥24 kg/m2的女性患POP的风险最大(OR=2.81,95%CI:2.05~3.84)。结论女性产次增加及BMI上升均增加POP的患病风险,因此加强健康教育,合理控制体重,注意孕期营养过剩能有效降低POP的发生风险。
Objective To investigate the effects of reproductive-related factors and body mass index (BMI) on pelvic organ prolapse (POP) and provide a scientific basis for the prevention and treatment of POP. Methods A stratified cluster random sampling method was used to survey 9 605 women in the Gansu province from April 2014 to August 2015. The non-conditional Logistic regression model was used to analyze the correlation between fertility-related factors and BMI and female POP Relevance. Results The risk of POP was 1.61 times (OR = 1.61, 95% CI: 1.39-1.88) and twice as high as that of women with birth 3 times or more (OR = 1.50, 95% CI: 1.27-1.77). The risk of severe POP increased with the increase of birth weight (χ_ (trend) ~ 2 = 47.63, P <0.01) after grouping by POP severity; Women with a history of assisted labor and BMI ≥24 kg / m2 had the highest risk of having POP (OR = 4.59, 95% CI: 1.91 to 11.04) compared with women of normal weight with a history of cesarean delivery, with normal BMI and normal delivery Women with giant births and BMI ≥24 kg / m2 had the highest risk of having POP (OR = 2.81, 95% CI: 2.05 to 3.84) compared with women with weight. Conclusions The increase of female births and the increase of BMI increase the risk of POP. Therefore, strengthening health education, controlling body weight reasonably and paying attention to excess nutrition in pregnancy can effectively reduce the risk of POP.