懷孕期間的急性尿液滯留-以臺灣全國人口為基礎的世代研究
陳建升1、呂瑾立2,3、楊昕禕3、王培中4、黃立中5、陳志成3,6、劉富舜7
衛生福利部新營醫院泌尿科1;國立成功大學醫學院公衛所2;嘉義基督教醫院醫學研究部3; 嘉義基督教醫院婦產科4; 嘉義基督教醫院精神科5;嘉義基督教醫院小兒科6; 嘉義基督教醫院急診科7
Acute Urinary Retention during Pregnancy – A Nationwide Population-based Cohort Study in Taiwan
Jeng-Sheng Chen1, Chin-Li Lu2, Hsin-Yi Yang3, Panchalli Wang4, Li-Chung Huang5, Solomon Chih-Cheng Chen6, Fu-Shun Liu7
1 Department of Urology, Sinying Hospital, Ministry of Health and Welfare, Sinying, Taiwan; 2 Department of Public Health, Medical College, National Cheng-Kung University, Tainan, Taiwan; 3 Department of Medical Research, Ditmanson Medical
Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; 4 Department of Gynecology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; 5.Department of Psychiatric, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; 6.Department of Pediatrics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan; 7.Department of Emergency, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.
Purpose: To study the epidemiology and risk factors of acute urinary retention (AUR) during pregnancy.
Materials and Methods: We included all cases of pregnancies with AUR reported in Taiwan’s Longitudinal Health Insurance Database from January 1, 1998, to December 31, 2011. Cases of AUR onset one day before delivery were excluded. The Cochrane-Armitage trend test and logistic regression analysis were used to evaluate the age distribution and types of deliveries of pregnant women. Chi-squared tests and Fisher's exact test were performed to examine the association among all covariates. The odds ratios (OR) and 95% confidence intervals (CI) were estimated.
Results: We identified 308 cases of AUR in 65,490 pregnancies. The risk of AUR during pregnancy was 0.47%. The peak incidence occurred between the 9th and 16th gestational weeks. Patients who experienced preterm delivery exhibited the highest risk for AUR (2.18%). Those with post-term delivery had the second highest risk (0.46%), and patients with a normal delivery exhibited the lowest risk (0.33%). Compared with normal delivery, preterm delivery carried a higher risk of AUR (OR: 6.33, 95% CI: 4.94-8.11). The AUR risk was higher for patients with advanced maternal age (>35 years-old) than it was for those in the younger group (< 20 years-old) (OR: 2.62, 95% CI: 1.18-5.81). Within the normal delivery group, higher incidences of urinary tract infection; inflammation of the pelvis, cervix, vagina, and vulva; genital herpes, previous abortion; and abnormal pelvis were noted in women with AUR than in those without AUR (all p values<0.05).
Conclusions: Women with advanced maternal age and those who experienced preterm delivery had an increased risk for AUR. The peak incidence of AUR in normal pregnancies occurred between the 9th and 16th gestational weeks. Urogenital infection, previous abortion, and abnormal pelvis were associated with AUR in women who underwent a normal delivery.