Bergström Cecilia, Persson Margareta, Nergård Kari-Anne, Mogren Ingrid
Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
Department of Nursing, Umeå University, Umeå, Sweden.
BMC Musculoskelet Disord. 2017 Sep 16;18(1):399. doi: 10.1186/s12891-017-1760-5.
Pelvic girdle pain (PGP) is not always a self-limiting condition. Women with more pronounced persistent PGP (PPGP) report poorer health status compared to women with less pronounced symptoms. The knowledge concerning the long-term consequences of PPGP is limited, thus more knowledge in this area is needed. The overall aim was to study the prevalence and predictors of PPGP 12 years after delivery.
This is a long-term follow-up study based on a previous cohort study that commenced in 2002. New questionnaire data 12 years postpartum were collected in 2014 and early 2015. The questionnaire was distributed to a total of 624 women from the initial cohort.
In total, 295 women (47.3%) responded to the questionnaire where 40.3% (n = 119) reported pain to a various degree and 59% (n = 174) reported no pain. Increased duration and/or persistency of pain, self-rated health, sciatica, neck and/or thoracic spinal pain, sick leave the past 12 months, treatment sought, and prescription and/or non-prescription drugs used were all associated with an statistically significant increase in the odds of reporting pain 12 years postpartum. Widespread pain was common and median expectation of improvement score was 5 on an 11-point numeric scale (interquartile range 2-7.50). More than one of five women (21.8%) reporting pain stated that they had been on sick leave the past 12 months and nearly 11% had been granted disability pension due to PPGP. No statistically significant differences were found between respondents and non-respondents regarding most background variables.
This study is unique as it is one of few long-term follow-up studies following women with PPGP of more than 11 years. The results show that spontaneous recovery with no recurrences is an unlikely scenario for a subgroup of women with PPGP. Persistency and/or duration of pain symptoms as well as widespread pain appear to be the strongest predictors of poor long-term outcome. Moreover, widespread pain is commonly associated with PPGP and may thus contribute to long-term sick leave and disability pension. A screening tool needs to be developed for the identification of women at risk of developing PPGP to enable early intervention.
骨盆带疼痛（PGP）并非总是一种自限性疾病。与症状较轻的女性相比，骨盆带疼痛更为明显且持续存在（PPGP）的女性报告的健康状况较差。关于PPGP长期后果的知识有限，因此该领域需要更多的知识。总体目标是研究产后12年PPGP的患病率及预测因素。
这是一项基于2002年开始的一项队列研究的长期随访研究。2014年和2015年初收集了产后12年的新问卷数据。问卷共发放给最初队列中的624名女性。
共有295名女性（47.3%）回复了问卷，其中40.3%（n = 119）报告有不同程度的疼痛，59%（n = 174）报告无疼痛。疼痛持续时间和/或持续性增加、自评健康状况、坐骨神经痛、颈部和/或胸椎疼痛、过去12个月的病假、寻求治疗以及使用的处方药和/或非处方药均与产后12年报告疼痛的几率在统计学上显著增加相关。广泛性疼痛很常见，在11分数字量表上改善评分的中位数为5分（四分位间距2 - 7.50）。报告疼痛的女性中超过五分之一（21.8%）表示她们在过去12个月休过病假，近11%因PPGP获得了残疾抚恤金。在大多数背景变量方面，回复者和未回复者之间未发现统计学上的显著差异。
本研究具有独特性，因为它是对患有PPGP超过11年的女性进行的少数长期随访研究之一。结果表明，对于一部分PPGP女性来说，无复发的自然恢复不太可能。疼痛症状的持续性和/或持续时间以及广泛性疼痛似乎是长期预后不良的最强预测因素。此外，广泛性疼痛通常与PPGP相关，因此可能导致长期病假和残疾抚恤金。需要开发一种筛查工具来识别有发生PPGP风险的女性，以便进行早期干预。
