Yamada Keiko, Kimura Takashi, Ikehara Satoyo, Cui Meishan, Kubota Yasuhiko, Wakaizumi Kenta, Takeda Takashi, Iso Hiroyasu
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Department of Psychology, McGill University, 2001 McGill College, Montreal, QC, H3A 1G1, Canada.
J Anesth. 2020 Apr;34(2):202-210. doi: 10.1007/s00540-019-02722-5. Epub 2019 Dec 16.
Analgesic medication epidemic during pregnancy is an important issue in Western countries. However, no large epidemiological study involving pregnant women with pain and their medication use has been conducted in Japan. This study examined the current situation of medication use for non-cancer pain during the perinatal period in Japan using national cohort data.
We analyzed 94,649 pregnant women who completed a self-report questionnaire investigating bodily pain and an interview-based medication use survey. Medication use before and during pregnancy and new medication administration/discontinuation during pregnancy were compared between women with and without pain during pregnancy using multivariable covariance analysis.
Mild pain was reported by 50.4% of pregnant women in the first trimester (survey 1) and 61.8% in the second/third trimester (survey 2). Moderate-to-severe pain was reported by 15.4% of women in survey 1 and 22.4% in survey 2. In survey 1, 6.2% of women used prescribed analgesics and 1.6% used over-the-counter analgesics. In survey 2, prescribed and over the counter analgesics were used by 12.2% and 0.8% of women, respectively. Other pain-related medications were rarely used (< 1.0%). Pregnant women with moderate-to-severe pain showed a lower proportion of discontinuation of analgesics and a higher proportion of new administration of prescription and transdermal analgesics compared with those without pain.
Although a large proportion of pregnant women experience pain, medication use for pain during pregnancy is low in Japan compared with Western countries (50-60%). Adequate treatment or support may be necessary for pregnant women experiencing pain in Japan.
孕期止痛药物的流行在西方国家是一个重要问题。然而,日本尚未开展涉及有疼痛症状的孕妇及其用药情况的大型流行病学研究。本研究利用全国队列数据调查了日本围产期非癌性疼痛的用药现状。
我们分析了94649名完成了关于身体疼痛的自我报告问卷以及基于访谈的用药情况调查的孕妇。使用多变量协方差分析比较了孕期有疼痛和无疼痛的女性在孕前和孕期的用药情况以及孕期新用药/停药情况。
在孕早期(调查1),50.4%的孕妇报告有轻度疼痛,在孕中/晚期(调查2)这一比例为61.8%。在调查1中,15.4%的女性报告有中度至重度疼痛,在调查2中这一比例为22.4%。在调查1中,6.2%的女性使用了处方镇痛药,1.6%的女性使用了非处方镇痛药。在调查2中,分别有12.2%和0.8%的女性使用了处方和非处方镇痛药。其他与疼痛相关的药物很少使用(<1.0%)。与无疼痛的孕妇相比,有中度至重度疼痛的孕妇停用镇痛药的比例较低,新使用处方和透皮镇痛药的比例较高。
尽管很大一部分孕妇经历疼痛,但与西方国家(50 - 60%)相比,日本孕期疼痛用药比例较低。对于日本有疼痛的孕妇,可能需要适当的治疗或支持。