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孕妇腰痛:必要之恶还是可避免之恶?

Low back pain in pregnant women: A necessary or an avoidable evil?

机构信息

Rheumatology Department, Kassab Orthopedics Institute, La Mannouba, Tunisia.

Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia.

出版信息

Musculoskeletal Care. 2023 Sep;21(3):865-870. doi: 10.1002/msc.1763. Epub 2023 Apr 3.

Abstract

OBJECTIVES

The aim of this study was to determine the prevalence, the main features and the potential risk factors of LBP in pregnant women.

METHODS

This cross-sectional study included 173 pregnant women in the third trimester. Non-inclusion criteria were severe mental disability and known previous history of musculoskeletal diseases. The participants were categorised into two groups: women with pregnancy-related LBP and pain-free women. Demographic, socio-professional, clinical and obstetrical data were compared between the two groups using the appropriate statistical tests.

RESULTS

The mean age was 32.2 ± 5.4 years [17-45]. Among them, 108 (62.4%) reported one or more episodes of LBP during at least 7 days, mostly in the third semester (n = 71). The presence of LBP was significantly associated with history of LBP in previous pregnancies and jobs requiring prolonged standing. Active jobs and the presence of gestational complications were significantly more common in pain-free women. In the multivariate analysis, LBP was independently predicted by the history of LBP in previous pregnancies and the absence of gestational complications.

CONCLUSIONS

The association of LBP with gestational complications as a protective factor has not yet been reported in previous studies. These complications are a common cause of hospitalisation, which represents a period of relative rest during pregnancy. Our results revealed that history of LBP in previous pregnancies, sedentary lifestyle prior to pregnancy and prolonged standing are the main risk factors of LBP. In contrast, rest and avoidance of physical overstrain during pregnancy may be protective factors.

摘要

目的

本研究旨在确定孕妇腰痛(LBP)的患病率、主要特征和潜在危险因素。

方法

这是一项横断面研究,共纳入 173 名处于妊娠晚期的孕妇。排除标准为严重精神残疾和已知的既往肌肉骨骼疾病史。将参与者分为两组:有妊娠相关性 LBP 的妇女和无痛的妇女。使用适当的统计检验比较两组间的人口统计学、社会职业、临床和产科数据。

结果

平均年龄为 32.2±5.4 岁(17-45 岁)。其中,108 名(62.4%)孕妇报告至少有 7 天出现过一次或多次腰痛,大多数发生在第三个学期(n=71)。腰痛的存在与既往妊娠中存在腰痛史和需要长时间站立的工作显著相关。无痛的妇女中,活跃的工作和存在妊娠并发症的情况明显更为常见。多变量分析显示,既往妊娠中存在腰痛史和无妊娠并发症可独立预测腰痛的发生。

结论

与妊娠并发症相关的腰痛作为保护因素,在以往研究中尚未有报道。这些并发症是住院的常见原因,这代表了妊娠期间相对休息的时期。我们的结果表明,既往妊娠中的腰痛史、妊娠前久坐的生活方式和长时间站立是腰痛的主要危险因素。相比之下,妊娠期间的休息和避免体力过度劳累可能是保护因素。

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