Department of Psychosomatics and Health Behaviour, Norwegian Institute of Public Health, Oslo, Norway Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Department of Psychosomatics and Health Behaviour, Norwegian Institute of Public Health, Oslo, Norway Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.
Br J Sports Med. 2016 Jul;50(13):817-22. doi: 10.1136/bjsports-2015-094921. Epub 2015 Oct 4.
To examine whether an association exists between exercise levels pre-pregnancy and pelvic girdle pain in pregnancy. Pelvic girdle pain in pregnancy has been associated with physical inactivity, a risk factor for adverse pregnancy outcomes.
We used data from a population-based cohort study including 39 184 nulliparous women with a singleton pregnancy enrolled in the Norwegian Mother and Child Cohort study. Pre-pregnancy exercise frequency and types were assessed by questionnaire in pregnancy week 17. Pelvic girdle pain, defined as combined pain in the anterior pelvis and in the posterior pelvis bilaterally, was self-reported in pregnancy week 30. Multivariable Poisson regression estimated risks of pelvic girdle pain associated with pre-pregnancy exercise. We examined a dose-response association of prepregnancy exercise frequency using restricted cubic splines. A test for non-linearity was also conducted. Final models were adjusted for pre-pregnancy BMI, age, education, history of low back pain and history of depression.
4069 women (10.4%) reported pelvic girdle pain in pregnancy and the prevalence among women who were non-exercisers prepregnancy was 12.5%. There was a non-linear association for pre-pregnancy exercise and risk of pelvic girdle pain (test for non-linearity, p=0.003). Compared to non-exercisers, women exercising 3-5 times weekly pre-pregnancy had a 14% lower risk of developing pelvic girdle pain in pregnancy (aRR 0.86, 95% CI 0.77 to 0.96). Taking part in high-impact exercises such as running, jogging, orienteering, ballgames, netball games and high-impact aerobics were associated with less risk of pelvic girdle pain.
Women who exercise regularly and engage in high-impact exercises before the first pregnancy may have a reduced risk of pelvic girdle pain in pregnancy.
探讨妊娠前运动水平与妊娠期间骨盆带疼痛之间是否存在关联。妊娠期间骨盆带疼痛与身体活动不足有关，后者是妊娠不良结局的一个危险因素。
我们使用了一项基于人群的队列研究的数据，该研究纳入了挪威母亲和儿童队列研究中 39184 名初产妇和单胎妊娠女性。妊娠 17 周时通过问卷评估妊娠前运动频率和类型。妊娠 30 周时自我报告双侧骨盆前区和后区的骨盆带疼痛。多变量泊松回归估计与妊娠前运动相关的骨盆带疼痛风险。我们使用限制立方样条检查了妊娠前运动频率的剂量反应关联。还进行了非线性检验。最终模型调整了妊娠前 BMI、年龄、教育程度、腰背疼痛史和抑郁史。
4069 名女性（10.4%）报告妊娠期间出现骨盆带疼痛，妊娠前非运动者的患病率为 12.5%。妊娠前运动与骨盆带疼痛风险之间存在非线性关联（非线性检验，p=0.003）。与非运动者相比，妊娠前每周运动 3-5 次的女性发生骨盆带疼痛的风险降低 14%（调整相对风险比为 0.86，95%CI 0.77 至 0.96）。参加跑步、慢跑、定向运动、球类运动、无挡板篮球运动和高冲击有氧运动等高强度运动与骨盆带疼痛风险降低相关。
妊娠前经常运动且从事高强度运动的女性，妊娠期间发生骨盆带疼痛的风险可能降低。
