产后尿失禁与产后抑郁、焦虑的相关性研究进展

doi:10.12280/gjfckx.20260135

摘要/Abstract

摘要：

产后尿失禁（postpartum urinary incontinence，PPUI）与产后抑郁、焦虑均为女性分娩后常见合并症，常共存并相互加剧，近年来逐渐成为临床交叉研究热点。现有证据表明，PPUI可能会使产后抑郁发生风险增加约45%，重度PPUI患者患中重度焦虑的风险可达无尿失禁者的3.77倍，且压力性尿失禁与抑郁、急迫性尿失禁与焦虑分别呈现特异性关联。其共病机制涵盖心理社会路径（羞耻感、社交回避、社会支持下降）及神经生物学路径（雌激素波动致血清素功能失调、中枢敏化等）。值得注意的是，文化经济背景可能调节二者关联，如宗教文化因素可加重尿失禁相关心理负担。当前研究以横断面设计为主，因果时序及动态演变规律尚不明确，且缺乏国内大样本纵向证据。未来需开展长期队列研究厘清因果关系，并建立盆底康复与心理健康的跨学科整合干预模式，为产妇提供更全面的健康管理方案。

关键词: 产后期, 尿失禁, 抑郁症, 产后, 焦虑, 产褥期疾病

Abstract:

Postpartum urinary incontinence (PPUI), postpartum depression and anxiety are common comorbidities in women after delivery. They often coexist and exacerbate each other, gradually becoming a hotspot in clinical interdisciplinary research in recent years. Existing evidence indicates that PPUI can increase the risk of postpartum depression by approximately 45%, and the risk of anxiety in patients with severe PPUI can be up to 3.77 times that of those without urinary incontinence. Moreover, stress urinary incontinence and depression, as well as urgency urinary incontinence and anxiety, show specific associations, respectively. The comorbidity mechanisms encompass psychosocial pathways (shame, social avoidance, decreased social support) and neurobiological pathways (estrogen fluctuations leading to serotonin dysfunction, central sensitization, etc.). Notably, cultural and economic backgrounds may modulate their association, for instance, religious and cultural factors that can exacerbate the psychological burden associated with urinary incontinence. Current research is predominantly based on cross-sectional designs, leaving the causal temporal sequence and dynamic evolution patterns unclear. Additionally, there is a lack of large-sample longitudinal evidence from large domestic studies. Future efforts should focus on conducting long-term cohort studies to clarify the causal relationship and establishing an interdisciplinary integrated intervention model combing pelvic floor rehabilitation with mental health support, aiming to provide more comprehensive health management strategies for postpartum women.

Key words: Postpartum period, Urinary incontinence, Depression, postpartum, Anxiety, Puerperal disorders

张璐思, 陈韶慧. 产后尿失禁与产后抑郁、焦虑的相关性研究进展[J]. 国际妇产科学杂志, 2026, 53(4): 459-462.

ZHANG Lu-si, CHEN Shao-hui. Research Progress on the Association between Postpartum Urinary Incontinence and Postpartum Depression and Anxiety[J]. Journal of International Obstetrics and Gynecology, 2026, 53(4): 459-462.

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