Lan Qianwen, Fu Allan Chak Lun, McKay Marnee J, Simic Milena, Castrillon Carlos Mesa, Wei Yuanye, Ferreira Paulo
Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia; Charles Perkins Centre Musculoskeletal Research Group, The University of Sydney, Australia.
Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia.
Eur J Obstet Gynecol Reprod Biol. 2024 Mar;294:180-190. doi: 10.1016/j.ejogrb.2024.01.027. Epub 2024 Jan 22.
To systematically investigate the association between musculoskeletal pain during pregnancy and birth outcomes including caesarean section, newborn birthweight, newborn birth length, and gestational age at birth.
Medline, Embase, Web of Science, Cinahl and Scopus were systematically searched to identify eligible studies. Odds ratios, mean differences, and confidence intervals were used to describe results. Risk of Bias was assessed using the Newcastle-Ottawa Scale for observational studies. GRADE (The Grading of Recommendation Assessment, Development, and Evaluation) was used to assess the quality of each outcome.
Seven studies were included with a total population of 85,991 participants. There is low- quality evidence that pregnant women with musculoskeletal pain had 1.59 greater odds to experience delivery by caesarean section compared to those without musculoskeletal pain ([OR] 1.59, 95 % confidence interval [CI] 1.09 to 2.31). Both newborn birth weight (Mean Difference [MD] 77.79 g, 95 % [CI] -23.09 to 178.67) and newborn birth length ([MD] 0.55 cm, 95 % [CI] -0.47 to 1.56) were not affected by musculoskeletal pain, with very low-quality and low-quality evidence, respectively. There was moderate evidence that pregnant women with musculoskeletal pain had shorter gestational age (weeks), although the effect was small and possibly not clinically relevant ([MD] -0.41, 95 % [CI] -0.41 to -0.07).
Pregnant women experiencing musculoskeletal pain are at greater odds of delivering their babies via caesarean than those without musculoskeletal pain, however, musculoskeletal pain during pregnancy does not appear to affect newborn birth weight, length, or gestational age at birth.
系统研究孕期肌肉骨骼疼痛与分娩结局之间的关联，分娩结局包括剖宫产、新生儿出生体重、新生儿出生身长和出生时的孕周。
对Medline、Embase、科学网、护理学与健康领域数据库（Cinahl）和Scopus进行系统检索，以确定符合条件的研究。采用比值比、平均差和置信区间来描述结果。使用纽卡斯尔-渥太华量表对观察性研究进行偏倚风险评估。采用推荐分级的评估、制定与评价（GRADE）方法评估每个结局的质量。
纳入7项研究，总样本量为85991名参与者。低质量证据表明，与无肌肉骨骼疼痛的孕妇相比，有肌肉骨骼疼痛的孕妇剖宫产的几率高1.59倍（比值比[OR]为1.59，95%置信区间[CI]为1.09至2.31）。肌肉骨骼疼痛对新生儿出生体重（平均差[MD]为77.79g，95%[CI]为-23.09至178.67）和新生儿出生身长（[MD]为0.55cm，95%[CI]为-0.47至1.56）均无影响，证据质量分别为极低质量和低质量。有中等质量证据表明，有肌肉骨骼疼痛的孕妇孕周较短（周数），尽管影响较小且可能与临床无关（[MD]为-0.41，95%[CI]为-0.41至-0.07）。
与无肌肉骨骼疼痛的孕妇相比，有肌肉骨骼疼痛的孕妇剖宫产的几率更高，然而，孕期肌肉骨骼疼痛似乎不会影响新生儿出生体重、身长或出生时的孕周。
