RESUMO
Objective:To analyze the current situation and influencing factors of rectus abdominis muscle separation in postpartum women.Methods:The clinical data of 3 368 postpartum women who underwent postpartum physical examination in Shenzhen Longgang maternal and child health hospital from June to October 2020 were retrospectively analyzed. The general data, rectus abdominis separation and pelvic organ prolapse were collected for cross-sectional investigation.Results:The incidence of rectus abdominis separation in postpartum women was 60.7% (2 045/3 368). <30 years old, ≥30 years old (56.8% (856/1 507) and 63.9% (1 189/1 861), χ2=17.54)). The increase of body mass during pregnancy was <16 kg, ≥16 kg (59.1% (1 351/2 285) and 64.1% (694/1 083), χ2=7.57)). Spontaneous labor and cesarean section (55.7% (1 262/2 266) and 71.7% (790/1 102), χ2=77.87)). Pregnancy 1, 2, ≥3 times (53.9% (645/1 196), 62.1% (702/1 131) and 67.1% (698/1 041), χ2=41.48). Production for 1, 2, ≥3 times (53.9% (877/1 628), 67.0% (1 016/1 517) and 68.2% (151/223), χ2=62.09)). History of macrosomia (68.7% (160/233) and 60.1% (1 885/3 135), χ2=6.64)). Prolapse of anterior vaginal wall (75.2% (1 559/2 072) and 37.5% (486/1 296), χ2=476.15), there were significant differences in the incidence of rectus abdominis separation (all P<0.05). Logistic regression analysis showed that ≥ 3 times pregnancies ( OR=1.572,95% CI=1.270-1.945),cesarean section ( OR=2.440,95% CI=2.050-2.905),macrosomia ( OR=1.660,95% CI=1.213-2.273), anterior vaginal prolapse( OR=7.324,95% CI=6.083-8.819) were risk factors of diastasis recti abdominis (all P<0.05). Conclusions:The incidence of rectus abdominis separation in postpartum women is high. Three or more pregnancies, cesarean section, history of macrosomia and prolapse of anterior vaginal wall play an important role in the occurrence of rectus abdominis separation.
RESUMO
Objective:To analyze the body composition and determinants of gestational diabetes mellitus(GDM), so that to provide basic data for prevent and control GDM further.Methods:All 1 553 pregnant women with GDM (GDM group) at 24-28 weeks of gestation were selected, and 1 298 pregnant women with normal glucose tolerance (NGT) at the same pregnancy were taken as the control group. The general data, body composition test data and 75 g oral glucose tolerance test results of the two groups were collected for statistical analysis. T-test was used for comparison between normal distribution measurement data groups, and counting data were compared χ 2 inspection. Results:The age of GDM group (31.30±4.63) years, the body mass index before pregnancy (21.78±3.11) kg/m 2, and the proportion of body fat content (30.77±5.26)% were all higher than that of NGT Group ((28.42±4.01) years, (20.74±3.04) kg/m 2, (27.76±5.56)%). The proportion of water content (50.46±4.11)%, protein content (13.91±1.27)%, and inorganic salt content (4.90±1.99)%, were lower than that of NGT Group ((52.11±3.97)%, (14.47±1.18)%, (5.71±2.26)%), and there were significant differences between the two groups (t values were 17.84, 9.03, 6.41, 8.67, 7.14 and 5.94, respectively; all P<0.001). The detection rates of advanced age 25.4%(394/1 553), family history of diabetes 23.1%(359/1 553), history of GDM 4.3%(67/1 553), history of polycystic ovary syndrome 0.6%(9/1 553) in GDM group were higher than those in NGT group (7.4%(96/1 298), 11.4%(148/1 298), 0.3%(4/1 298), 0.1%(1/1 298)). There were statistically significant differences between the two groups(χ 2 values were 160.49, 66.36, 46.73 and 5.11, respectively; all P<0.05). The proportion of lean, normal, overweight and obese people in GDM group was 11.5%(179/1 553), 65.8%(1 022/1 553), 18.5%(287/1 553), 4.2%(65/1 553), and 22.6%(293/1 298), 63.0%(818/1 298), 11.4%(148/1 298), 3.0%(39/1 298), respectively. The body fat content in GDM group was 1.9%(30/1 553), 45.5%(707/1 553), 52.6%(817/1 553), and 8.1%(105/1 298), 54.0%(701/1 298), and 37.9%(492/1 298), respectively. The protein content in GDM group was 95.9%(1 489/1 553), 4.1%(64/1 553), 0(0/1 553), and 89.5%(1 162/1 298), 10.5%(136/1 298), 0(0/1 298), respectively. The low, normal and high water content in GDM group were 36.3%(564/1 553), 54.3%(843/1 553), 9.4%(146/1 553), and 22.5%(292/1 298), 58.8%(763/1 298), 18.7%(243/1 298), respectively. There were statistically significant differences in the overall distribution of body mass index before pregnancy and the contents of body water, body fat and protein between the two groups (statistical values were 78.89, 100.21, 43.80 and 92.54, all P<0.001). Logistic analysis showed that old age ( OR=3.462, 95% CI=2.737-4.380), overweight before pregnancy ( OR=1.296, 95% CI=1.031-1.628), family history of diabetes ( OR=2.061, 95% CI=1.676-2.535), history of GDM ( OR=12.688, 95% CI=4.577-35.169), high body fat content ( OR=1.607, 95% CI=1.234-2.092), low water content ( OR=1.493, 95% CI=1.025-2.175) were the risk factors of GDM (all P<0.05). Low body fat content ( OR=0.341, 95% CI=0.151-0.768) was the protective factor of GDM ( P<0.05). Conclusions:In addition to the traditional risk factors such as body mass index before pregnancy, old age, family history of diabetes, and history of GDM, the contents of body water and body fat also played an important role in the occurrence of GDM.