Relationship between rectus abdominis separation,pelvic floor muscle strength,and pelvic floor sEMG parameters with postpartum stress urinary incontinence in primiparas
Objective This study aimed to analyze the relationship between rectus abdominis separation,pelvic floor muscle strength,and pelvic floor surface electromyography(sEMG)parameters with postpartum stress urinary incontinence(SUI)in primiparas.It explores the influencing factors of postpartum SUI and evaluates the predictive value of rectus abdominis separation,pelvic floor muscle strength,and sEMG parameters for postpartum SUI in primiparas.Methods A total of 116 primiparas who delivered at Shanghai First Maternity and Infant Hospital from February 2022 to February 2023 were select-ed for the study.According to the occurrence of SUI,they were allocated to an SUI group(n=35)and a non-SUI group(n=81).The rectus abdominis separation,pelvic floor muscle strength,and sEMG parameters were compared between the two groups.Stepwise logistic regression was used to analyze the influencing factors for postpartum SUI in primiparas.The receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of rectus abdominis separation,pel-vic floor muscle strength,and sEMG parameters for postpartum SUI.Results No statistically significant differences were noted in age,gestational weeks,pre-pregnancy body mass index(BMI),gestational weight gain,neonatal weight,and the proportion of vaginal surgical delivery between the two groups(P>0.05).The proportion of natural deliveries in the SUI group was significantly higher than in the non-SUI group(P<0.05).The SUI group had greater rectus abdominis separa-tion,lower pelvic floor muscle strength,lower maximum value during the fast contraction phase,lower average value during the tense contraction phase,lower variability during the tense contraction phase,lower average value during the endurance contraction phase,and lower variability during the endurance contraction phase of sEMG parameters compared to the non-SUI group,all with statistical significance(P<0.05).Stepwise logistic regression analysis showed that natural delivery,rectus abdominis separation,pelvic floor muscle strength,variability during the tense contraction phase of sEMG,and aver-age value during the endurance contraction phase were influencing factors of postpartum SUI in primiparas(P<0.05).ROC curve analysis indicated that the areas under the ROC curve(AUC)for rectus abdominis separation,pelvic floor mus-cle strength,and average value during the endurance contraction phase,as well as their combined detection,in predicting postpartum SUI in primiparas were 0.838,0.874,0.870,and 0.957,respectively(P<0.05).Conclusion Primiparas with postpartum SUI exhibit rectus abdominis separation,reduced pelvic floor muscle strength,and decreased sEMG pa-rameters.Monitoring rectus abdominis separation,pelvic floor muscle strength,and sEMG parameters has certain predic-tive value for postpartum SUI in primiparas.