Aberdeen Pain Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, School of Medicine and Dentistry, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK.
Eur J Pain. 2012 Jan;16(1):134-9. doi: 10.1016/j.ejpain.2011.05.015.
The aim was to examine the relationship between gestational age and birthweight and adult chronic widespread pain (CWP).
A prospective cohort study of 18,558 participants recorded birthweight and gestation at birth.
Participants were categorised by gestation (fullterm ≥37 weeks; preterm <37 week) and birthweight (full birthweight (FBW) ≥2.5 kg; low birthweight (LBW) 1.5-2.5 kg; and very low birthweight (VLBW) <1.5 kg).
The presence or absence of CWP was measured by self-completed questionnaire in 8572 participants at age 45 yrs. Risk ratios were calculated using Poisson regression. Adjustment was made for potential confounding factors.
Premature birth was associated with a 26% increase in the risk of CWP compared to fullterm birth, although this was not statistically significant (risk ratio 1.26, 95% confidence interval 0.95-1.67). This increased risk was robust to adjustment for sex, social class at birth and age 42 yrs, or birthweight, but was completely attenuated when adjusted for childhood behavioural problems and adult psychiatric disorder. LBW was not associated with an increased risk of CWP (RR 1.01, 95%CI 0.78-1.32). VLBW was associated with a non-significant increased risk (RR 1.48, 0.42-5.22) although there was insufficient study power to examine this relationship in the context of other factors.
Premature birth and VLBW are associated with increased risk of adult CWP although these effects are modest, and not statistically significant. Although not conclusive in itself, this study lends support to the theory that adult chronic pain may have its origins - at least in part - in very early life.
研究目的是探讨胎龄与出生体重和成人慢性广泛性疼痛（CWP）之间的关系。
这项前瞻性队列研究对 18558 名参与者进行了记录，记录了出生时的出生体重和胎龄。
根据胎龄（足月≥37 周；早产<37 周）和出生体重（足月儿（FBW）≥2.5kg；低出生体重（LBW）1.5-2.5kg；极低出生体重（VLBW）<1.5kg）对参与者进行分类。
通过 8572 名参与者在 45 岁时的自我完成问卷测量 CWP 的存在或不存在。使用泊松回归计算风险比。调整了潜在的混杂因素。
与足月出生相比，早产与 CWP 风险增加 26%有关，但无统计学意义（风险比 1.26，95%置信区间 0.95-1.67）。这种增加的风险在调整性别、出生时的社会阶层和 42 岁时的年龄或出生体重后仍然存在，但在调整儿童行为问题和成年精神障碍后完全减弱。LBW 与 CWP 风险增加无关（RR 1.01，95%CI 0.78-1.32）。VLBW 与风险增加无显著相关性（RR 1.48，0.42-5.22），但由于研究能力不足，无法在其他因素的背景下对此关系进行检查。
早产和极低出生体重与成人 CWP 风险增加有关，尽管这些影响较小，且无统计学意义。尽管本身并不确定，但这项研究支持了这样一种理论，即成人慢性疼痛至少部分起源于生命早期。
