Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424, Oslo, Norway.
Department of Mathematics, University of Bergen, Bergen, Norway.
BMC Public Health. 2020 Oct 15;20(1):1556. doi: 10.1186/s12889-020-09480-0.
Associations between childbirths and subsequent risk of low back pain (LBP) have not been clarified. Changes in sex hormone levels or lumbar posture during pregnancy may have an impact on LBP later in life. The purpose of this study was to explore associations between the number of childbirths, age at childbirths and prevalence of chronic LBP in a general population of women.
Data were obtained from the Norwegian community-based Nord-Trøndelag Health Study, HUNT2 (1995-1997). Women aged 20-69 years indicated whether they suffered from chronic LBP, defined as LBP persisting at least 3 months continuously during last year. Information about LBP was collected from 3936 women who had experienced no childbirths, 3143 women who had delivered one child only and 20,584 women who had delivered 2 or more children. Of these, 7339 women reported chronic LBP. The 595 women who were pregnant when information was collected were considered separately, regardless of previous births, with 80 women reporting chronic LBP. Associations with prevalence of chronic LBP were examined by generalised linear modelling with adjustment for potential confounders in a cross-sectional design.
Women who had delivered one child only showed a higher prevalence of chronic LBP than women with no childbirths (prevalence ratio (PR) 1.11; 95% CI: 1.01-1.22). Among women with one or more childbirths, no overall change in prevalence could be demonstrated with an increasing number of children in analyses adjusted for age at first delivery. In women with at least two childbirths, an age less than 20 years at first childbirth was associated with an increased prevalence of chronic LBP (PR 1.36; 95% CI: 1.25-1.49; compared with age 25-29 years). No association was observed between age at last delivery and chronic LBP. The lowest prevalence of chronic LBP was found among women who were currently pregnant (PR 0.80; 95% CI: 0.63-1.00; compared with women with no childbirths).
Having experienced at least one childbirth seems to be associated with a higher prevalence of chronic LBP later in life. A young age at first childbirth is also associated with a long-lasting increased prevalence.
分娩与随后发生腰痛（LBP）的风险之间的关联尚未明确。怀孕期间性激素水平或腰椎姿势的变化可能会对以后的 LBP 产生影响。本研究旨在探讨一般人群中生育次数、分娩年龄与慢性 LBP 患病率之间的关系。
数据来自挪威基于社区的北特伦德拉格健康研究（HUNT2）（1995-1997 年）。20-69 岁的女性报告了是否患有慢性 LBP，定义为过去一年中持续至少 3 个月的 LBP。3936 名未生育过的女性、3143 名仅生育过一名子女的女性和 20584 名生育过 2 名或更多子女的女性报告了 LBP 信息。其中 7339 名女性报告了慢性 LBP。在收集信息时怀孕的 595 名女性被单独考虑，无论之前是否有过分娩，其中 80 名女性报告了慢性 LBP。在横断面设计中，通过广义线性模型调整潜在混杂因素，研究了慢性 LBP 患病率与生育次数和分娩年龄的相关性。
仅生育过一名子女的女性慢性 LBP 患病率高于未生育过的女性（患病率比 1.11；95%CI：1.01-1.22）。在有 1 次或多次分娩的女性中，在调整首次分娩年龄后，分析结果并未显示儿童数量增加与患病率变化之间存在关联。在至少有 2 次分娩的女性中，首次分娩年龄小于 20 岁与慢性 LBP 患病率增加相关（患病率比 1.36；95%CI：1.25-1.49；与 25-29 岁年龄组相比）。最后一次分娩年龄与慢性 LBP 之间无关联。目前怀孕的女性慢性 LBP 患病率最低（患病率比 0.80；95%CI：0.63-1.00；与未生育的女性相比）。
至少生育一次似乎与以后发生慢性 LBP 的风险较高有关。首次分娩年龄较小也与长期患病率增加有关。
