Gutke Annelie, Josefsson Ann, Oberg Birgitta
Department of Health and Society, Division of Physiotherapy, Linköping University, Linköping, Sweden.
Spine (Phila Pa 1976). 2007 Jun 1;32(13):1430-6. doi: 10.1097/BRS.0b013e318060a673.
A cohort study.
To investigate the possible association of lumbopelvic pain and postpartum depression and differences in the prevalence of depressive symptoms among women without lumbopelvic pain and women classified as having pelvic girdle pain (PGP) and/or lumbar pain.
Lumbopelvic pain and depression are common pregnancy complications, but their comorbidity has rarely been evaluated and has not been studied in relation to subgroups of lumbopelvic pain.
In a cohort of consecutively enrolled pregnant women, the Edinburgh Postnatal Depression Scale was used to evaluate depressive symptoms at 3 months postpartum, applying a primary screening cutoff of > or =10 and a cutoff of > or =13 for probable depression. Women were classified into lumbopelvic pain subgroups by means of mechanical assessment of the lumbar spine, standard history, pelvic pain provocation tests, a pain drawing, and the active straight leg raising test.
The postpartum cohort (n = 267) comprised 180 (67%) women without lumbopelvic pain, 44 (16%) with PGP, 29 (11%) with lumbar pain, and 14 (5%) with combined PGP and lumbar pain. Applying a cutoff of > or =10, postpartum depressive symptoms were more prevalent in women with lumbopelvic pain (27 of 87, 31%; 95% confidence interval, 26%-36%) than in women without lumbopelvic pain (17 of 180, 9%; 95% confidence interval, 5%-13%; P < 0.001). The comorbidity of lumbopelvic pain and depressive symptoms was 10%. Depressive symptoms were more prevalent in women with lumbar pain versus women without lumbopelvic pain when applying cutoffs of > or =10 or > or =13 (P < or = 0.002); whereas for women with PGP, this comparison was significant only at the screening level of > or =10 (P = 0.01).
Postpartum depressive symptoms were 3 times more prevalent in women having lumbopelvic pain than in those without. This comorbidity highlights the need to consider both symptoms in treatment strategies.
队列研究。
调查腰骶部疼痛与产后抑郁之间可能存在的关联，以及无腰骶部疼痛的女性与被归类为患有骨盆带疼痛（PGP）和/或腰部疼痛的女性在抑郁症状患病率上的差异。
腰骶部疼痛和抑郁是常见的妊娠并发症，但它们的合并症很少被评估，并且尚未针对腰骶部疼痛的亚组进行研究。
在一组连续入组的孕妇中，使用爱丁堡产后抑郁量表在产后3个月评估抑郁症状，主要筛查临界值设定为≥10，可能抑郁的临界值设定为≥13。通过对腰椎进行力学评估、标准病史、骨盆疼痛激发试验、疼痛绘图以及主动直腿抬高试验，将女性分为腰骶部疼痛亚组。
产后队列（n = 267）包括180名（67%）无腰骶部疼痛的女性、44名（16%）患有PGP的女性、29名（11%）患有腰部疼痛的女性以及14名（5%）患有PGP合并腰部疼痛的女性。采用≥10的临界值时，有腰骶部疼痛的女性产后抑郁症状的患病率（87例中的27例，31%；95%置信区间，26% - 36%）高于无腰骶部疼痛的女性（180例中的17例，9%；95%置信区间，5% - 13%；P < 0.001）。腰骶部疼痛与抑郁症状的合并症发生率为10%。采用≥10或≥13的临界值时，患有腰部疼痛的女性抑郁症状的患病率高于无腰骶部疼痛的女性（P ≤ 0.002）；而对于患有PGP的女性，这种比较仅在筛查临界值≥10时具有统计学意义（P = 0.01）。
有腰骶部疼痛的女性产后抑郁症状的患病率是无腰骶部疼痛女性的3倍。这种合并症突出了在治疗策略中需要同时考虑这两种症状的必要性。
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