Larsen E C, Wilken-Jensen C, Hansen A, Jensen D V, Johansen S, Minck H, Wormslev M, Davidsen M, Hansen T M
Department of Gynecology and Obstetrics, Herlev Hospital, University of Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 1999 Feb;78(2):105-10.
Previous studies concerning symptom-giving pelvic girdle relaxation in pregnancy have to our knowledge been retrospective. We wanted to 1) determine the incidence during pregnancy and the prevalence two, six, and twelve months post partum, 2) identify possible predisposing factors, and 3) determine the frequency and duration of sicklisting, prospectively.
A cohort of 1600 consecutive pregnant women filled in a questionnaire. At the routine prenatal examinations they were asked about pelvic pain. Those who fulfilled the inclusion criteria were examined by a rheumatologist to confirm the diagnosis. The affected women were seen again two, six, and twelve months post partum. All participants were asked about sicklisting in pregnancy.
The incidence during pregnancy was 14%, the prevalence two, six, and twelve months post partum were 5%, 4%, and 2% respectively. Multivariate analysis indicates that the most important predisposing factor is pelvic pain in a previous pregnancy. Other factors were uncomfortable working conditions, lack of exercise, and previous low back pain and low abdominal pain. At least 37% of the women with symptom-giving pelvic girdle relaxation had been sicklisted in pregnancy due to pelvic pain, on average for twelve weeks.
Symptom-giving pelvic girdle relaxation is a considerable problem both in pregnancy and post partum. The occupational risk can possibly be prevented. The syndrome has a great social impact because of the frequent sicklisting.
据我们所知，以往关于孕期出现症状的骨盆带松弛的研究均为回顾性研究。我们希望：1）确定孕期发病率以及产后两个月、六个月和十二个月的患病率；2）识别可能的诱发因素；3）前瞻性地确定病假的频率和时长。
1600名连续入组的孕妇填写了一份问卷。在常规产前检查时，询问她们是否有骨盆疼痛。符合纳入标准的孕妇由风湿病专家进行检查以确诊。受影响的女性在产后两个月、六个月和十二个月时再次接受检查。询问所有参与者孕期是否请过病假。
孕期发病率为14%，产后两个月、六个月和十二个月的患病率分别为5%、4%和2%。多因素分析表明，最重要的诱发因素是既往妊娠时的骨盆疼痛。其他因素包括工作条件不佳、缺乏运动以及既往的腰痛和下腹痛。至少37%出现症状的骨盆带松弛女性因骨盆疼痛在孕期请过病假，平均病假时长为12周。
出现症状的骨盆带松弛在孕期和产后都是一个相当严重的问题。职业风险或许可以预防。由于频繁请病假，该综合征具有很大的社会影响。
