Ocurrance of Pregnancy Striae and Its Predictive Risk Factors in Nulliparous Women reffering to Health-Therapeutic Centers in Tabriz City: A Retrospective Cohort Study

Abstract

Striae gravidarum, which appear as lines on the skin of the abdomen, breasts, buttocks, and thighs of pregnant women, can cause itching and an unsightly appearance, negatively impacting the daily lives and psychosocial health of pregnant women. Given the high prevalence of striae gravidarum in pregnant women and its negative impact on their physical and psychosocial health, and the lack of adequate studies in this region, this study was conducted to investigate the incidence of striae gravidarum and its predictive risk factors in nulliparous women. Methods: This retrospective cohort study was conducted on 150 nulliparous pregnant women in the third trimester of pregnancy between weeks 35-38 of pregnancy with a visit to 10 urban health centers in Tabriz in 2024. Sampling was done by convenience method. Data including demographic characteristics, maternal anthropometric characteristics and newborn weight, which were completed after delivery, and risk factors for striae gravidarum such as hormonal factors, genetic factors, gestational diabetes, family history of striae, striae gravidarum and pruritus were collected through questionnaires and physical examination and were analyzed using statistical analysis including Chi-square test, independent t-test and Fisher's exact test. The severity of striae gravidarum and the severity of pruritus were evaluated using the Davey and Kamini methods, respectively. To investigate the predictive factors of striae gravidarum, bi-state logistic regression analysis was used. Results: Among 150 nulliparous pregnant women referred to urban health centers in Tabriz, 110 (73.3%) had striae gravidarum. Among these individuals, 27 (18%) had moderate striae gravidarum (1.81 ± 0.39) and 83 (55.3%) had severe striae gravidarum (6.49 ± 1.50). In the study population, 67 women (44.7%) experienced pruritus, of which 54 (36%) had mild pruritus, 11 (7.3%) had moderate pruritus, only 1 (0.7%) had severe pruritus, and 1 (0.7%) had very severe pruritus. There was a significant difference in the incidence and severity of pruritus between the groups with and without striae (P = 0.035).There was no significant difference between the groups with and without striae in terms of the variables of maternal height (P = 0.531), weight changes during pregnancy (P = 0.595), birth weight of the newborn (P = 0.164), education level (P = 0.136), occupation, skin color, family history of striae gravidarum in first-degree relatives, intake of fluids, vegetables and fruits, and bowel function (constipation), as well as the gender of the newborn and pregnancy status. However, there was a statistically significant difference between the two groups in terms of age (P = 0.008), weight (P = 0.013), BMI (P = 0.032), household income (P = 0.001), and level of physical activity (exercise) (P = 0.025). Based on the logistic regression test, age, weight, BMI, family income, and exercise were identified as predictors of striae gravidarum.