Department of Occupational Medicine, Herning Regional Hospital, Herning, Denmark.
Acta Obstet Gynecol Scand. 2011 Oct;90(10):1132-9. doi: 10.1111/j.1600-0412.2011.01141.x. Epub 2011 May 20.
To investigate the association between pre-pregnancy overweight/obesity and pregnancy-related pelvic pain.
Nested case-control study.
The Danish National Birth Cohort, a cohort of pregnant women and their children recruited 1996-2002.
The women were interviewed twice during pregnancy and twice after childbirth. The first pregnancy interview provided information on self-reported pre-pregnancy body mass index (BMI) and possible confounders, while data on pregnancy-related pelvic pain came from an interview six months postpartum. Cases (n=2 271) were selected on the basis of self-reported pelvic pain, and controls were randomly selected among women who did not report pelvic pain (n=2 649). We used logistic regression analysis to calculate pregnancy-related pelvic pain odds ratios (OR (95% confidence intervals)) according to pre-pregnant BMI.
Self-reported pregnancy-related pelvic pain. Results. In the total cohort, 18.5% of all pregnant women reported pregnancy-related pelvic pain. In the nested case-control study, the adjusted ORs for overall pelvic pain were 0.9 (0.7-1.2) in underweight women, 1.2 (1.1-1.4) in overweight women, 1.5 (1.2-2.0) in obese women Class 1 (30≤BMI<35), and 1.9 (1.3-2.8) in obese women Class 2 + 3 (BMI≥35), all relative to normal weight women. The correspondent ORs for severe pelvic pain were 0.8 (0.6-1.2), 1.4 (1.2-1.7), 1.7 (1.3-2.2), and 2.3 (1.6-3.4). The associations were stronger among women who had not given birth before.
The risk of pregnancy-related pelvic pain increased with pre-pregnancy BMI in an exposure-response relation and potentially adds another maternal complication to obesity.
探讨孕前超重/肥胖与妊娠相关骨盆痛的关系。
巢式病例对照研究。
丹麦全国出生队列，1996-2002 年招募的孕妇及其子女队列。
在妊娠期间和分娩后两次对女性进行访谈。第一次妊娠访谈提供了自我报告的孕前体重指数（BMI）和可能的混杂因素信息，而妊娠相关骨盆痛的数据来自产后 6 个月的访谈。病例（n=2271）是基于自我报告的骨盆痛选择的，对照组是在没有报告骨盆痛的女性中随机选择的（n=2649）。我们使用逻辑回归分析根据孕前 BMI 计算妊娠相关骨盆痛的比值比（OR（95%置信区间））。
自我报告的妊娠相关骨盆痛。结果：在整个队列中，18.5%的孕妇报告了妊娠相关骨盆痛。在巢式病例对照研究中，总体骨盆痛的调整后 OR 为：体重不足的女性为 0.9（0.7-1.2），超重的女性为 1.2（1.1-1.4），肥胖女性 1 类（30≤BMI<35）为 1.5（1.2-2.0），肥胖女性 2 类+3 类（BMI≥35）为 1.9（1.3-2.8），均与正常体重女性相比。严重骨盆痛的对应 OR 分别为 0.8（0.6-1.2）、1.4（1.2-1.7）、1.7（1.3-2.2）和 2.3（1.6-3.4）。对于未生育过的女性，这些关联更强。
孕前 BMI 与妊娠相关骨盆痛呈暴露-反应关系，风险随着 BMI 的增加而增加，这可能为肥胖症增加了另一种产妇并发症。
