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目的探讨孕期瑜伽训练对孕产妇盆底肌力、尿失禁及分娩情况的影响。方法前瞻性纳入2016年1月—12月正常健康妊娠女性200例,随机分为瑜伽组和对照组,各100例。对照组给予常规产前检查和围产期健康教育,瑜伽组在对照组基础上,自孕16 w至孕37 w在专业人员指导下进行瑜伽训练。对比两组盆底肌力变化、孕期和产后尿失禁发生率、自然分娩率、自然分娩各产程时间。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果瑜伽组孕24 w、36 w、产后6 w盆底肌力[深部(3.6±1.5)、(3.2±1.4)、(2.8±1.2)分;浅部(3.5±1.4)、(3.1±1.5)、(2.6±1.3)分]优于对照组[深部(3.2±1.3)、(2.8±1.2)、(2.4±1.0)分;浅部(3.1±1.2)、(2.7±1.3)、(2.1±1.1)分](均P<0.05);瑜伽组孕24 w、36 w和产后6 w尿失禁发生率(14%、19%、13.2%)低于对照组(26%、33%、27.4%)(均P<0.05);瑜伽组自然分娩率76%高于对照组62%(P<0.05);瑜伽组自然分娩第二产程[(42.5±18.2)min]短于对照组[(53.8±25.7)min](P<0.05)。结论孕期瑜伽训练有助于改善盆底肌力,减少孕期和产后尿失禁的发生率、提高自然分娩率、缩短第二产程时间。
Objective To investigate the effects of pregnancy training on pelvic floor muscle strength, urinary incontinence and childbirth in pregnant women. Methods 200 women with normal healthy pregnancy from January to December in 2016 were prospectively included and randomly divided into yoga group and control group, with 100 cases each. The control group was given routine prenatal care and perinatal health education. The yoga group underwent yoga training under the guidance of professional staff from 16 weeks pregnant to 37 weeks pregnant on the basis of the control group. The changes of pelvic floor muscle strength, incidence of pregnancy and postpartum urinary incontinence, spontaneous delivery rate and birth time of spontaneous labor were compared between the two groups. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results In the yoga group, the strength of the pelvic floor at 24 w, 36 w and 6 w postpartum was significantly lower than that of the control group (3.6 ± 1.5, 3.2 ± 1.4, 2.8 ± 1.2, 3.5 ± 1.4, 3.1 ± 1.5, ), (2.6 ± 1.3) points compared with the control group [deep (3.2 ± 1.3), (2.8 ± 1.2), (2.4 ± 1.0) (P <0.05). The incidence of urinary incontinence (14%, 19%, 13.2%) in the yoga group at 24 weeks pregnant, 36 weeks pregnant and 6 weeks postpartum was lower than that in the control group (26%, 33%, 27.4% (P <0.05). The rate of spontaneous delivery in yoga group was 76% higher than that in control group (P <0.05). The rate of spontaneous delivery in spontaneous yoga group was significantly shorter than that in control group [(42.5 ± 18.2) min ± 25.7) min] (P <0.05). Conclusion Yoga training during pregnancy helps to improve pelvic floor muscle strength, reduce the incidence of urinary incontinence during pregnancy and postpartum, improve the rate of natural childbirth and shorten the second stage of labor.