Juhl Mette, Andersen Per Kragh, Olsen Jørn, Andersen Anne-Marie Nybo
National Institute of Public Health, 5, Øster Farimagsgade, DK-1399 Copenhagen K, Denmark.
J Epidemiol Community Health. 2005 Jul;59(7):580-5. doi: 10.1136/jech.2004.029520.
The sparse knowledge of the aetiology of pelvic pain in pregnancy makes evidence based prevention a limited option. The aim of this study was to examine the relation between pelvic pain in pregnancy and physical and psychosocial working conditions.
This study used self reported data on working conditions for 1219 cases and 1539 controls, sampled as a nested case-control study within the Danish national birth cohort. Cases and controls were selected on the basis of self reported pelvic pain intensity, pain localisation, and pain impact on daily living activities. Exposure data were collected prospectively; early in pregnancy and before the onset of pelvic pain. Main outcome measures were odds ratios for pelvic pain in pregnancy as a function of physical and psychosocial working conditions.
Pregnant women with fixed evening work and with rotating shifts (without night shift) had odds ratios for pelvic pain in pregnancy of 1.76 (95% confidence intervals 1.04 to 2.96) and 1.65 (1.22 to 2.24), respectively, compared with women with day work. Physically strenuous work was associated with an almost 50% increased risk of pelvic pain in pregnancy (1.47; 1.17 to 1.84). In women who were under high psychosocial strain at work odds ratio was 1.39 (1.12 to 1.74) compared with women with low job strain.
Both physically and psychosocially demanding working conditions, measured by physically strenuous work, rotating shifts, and high job strain, are associated with an increased reporting of pelvic pain in pregnancy.
由于对孕期骨盆疼痛病因的了解有限,基于证据的预防措施选择受限。本研究旨在探讨孕期骨盆疼痛与身体及心理社会工作条件之间的关系。
本研究采用了1219例病例和1539例对照的自我报告工作条件数据,作为丹麦国家出生队列中的巢式病例对照研究进行抽样。病例和对照根据自我报告的骨盆疼痛强度、疼痛部位以及疼痛对日常生活活动的影响来选择。暴露数据是前瞻性收集的;在怀孕早期且骨盆疼痛发作之前。主要结局指标是孕期骨盆疼痛的比值比,作为身体及心理社会工作条件的函数。
与从事日班工作的女性相比,从事固定夜班工作和轮班工作(无夜班)的孕妇孕期骨盆疼痛的比值比分别为1.76(95%置信区间1.04至2.96)和1.65(1.22至2.24)。体力要求高的工作与孕期骨盆疼痛风险增加近50%相关(1.47;1.17至1.84)。与工作心理社会压力低的女性相比,工作心理社会压力高的女性比值比为1.39(1.12至1.74)。
以体力要求高的工作、轮班工作和高工作压力衡量的身体和心理社会要求高的工作条件,均与孕期骨盆疼痛报告增加相关。