Department of Orthopedics, Brown University, Providence, Rhode Island, USA.
Department of Orthopedics, Brown University, Providence, Rhode Island, USA.
World Neurosurg. 2024 Oct;190:e525-e536. doi: 10.1016/j.wneu.2024.07.165. Epub 2024 Jul 27.
Prior reviews investigating the impact of pregnancy on adolescent idiopathic scoliosis (AIS) have reached different conclusions and a meta-analysis of curve progression among pregnant females with AIS and its effects on clinical outcomes has not previously been performed.
A comprehensive search of major bibliographic databases (PubMed, Embase, and Scopus) was conducted for articles pertaining to spinal curve progression during pregnancy among patients with AIS. Patient demographics, scoliotic curve outcomes, and patient-reported quality of life measures were extracted.
Ten studies, including 857 patients with a mean age of 28.7 years, were included. Before pregnancy, 42.1% had undergone spinal fusion and 59.0% had a thoracic curve. Based on prepregnancy and postpregnancy radiographs, the curve increased from 33.9°-38.5°, and meta-analysis revealed a curve progression of 3.6° (range = -5.85 to 1.25, P = 0.003), primarily arising from loss of correction in the unfused group (Unfused = -5.0, P = 0.040; Fused = -3.0, P = 0.070). At the same time, 45.9% patients reported increased low back pain and many reported a negative body self-image and limitations in sexual function. However, 5 studies noted that pregnancy and number of pregnancies were not associated with curve progression, and multiple studies identified similar quality of life-related changes in non-pregnant patients with AIS.
Among unfused pregnant females with AIS, the spinal curvature increased significantly by 5.0° from before to after pregnancy. However, these changes may be independent of pregnancy status and occur with time. Such curve progression can contribute to a negative body self-image, low back pain, and functional limitations irrespective of pregnancy state.
先前的研究调查了妊娠对青少年特发性脊柱侧凸（AIS）的影响，但得出的结论各不相同，而且之前没有对 AIS 孕妇脊柱曲线进展及其对临床结果的影响进行荟萃分析。
对主要文献数据库（PubMed、Embase 和 Scopus）进行全面检索，以获取有关 AIS 患者妊娠期间脊柱曲线进展的文章。提取患者人口统计学、脊柱侧凸曲线结果和患者报告的生活质量指标。
纳入了 10 项研究，共 857 例患者，平均年龄 28.7 岁。妊娠前，42.1%的患者接受了脊柱融合术，59.0%的患者存在胸弯。根据妊娠前和妊娠后的 X 线片，曲线增加了 33.9°-38.5°，荟萃分析显示曲线进展了 3.6°（范围为-5.85 至 1.25，P=0.003），主要是由于未融合组的矫正丢失（未融合组为-5.0，P=0.040；融合组为-3.0，P=0.070）。与此同时，45.9%的患者报告腰痛加重，许多患者报告身体自我形象不佳和性功能受限。然而，有 5 项研究指出，妊娠和妊娠次数与曲线进展无关，并且多项研究发现 AIS 非妊娠患者的生活质量相关变化相似。
在未融合的妊娠 AIS 女性中，脊柱曲线从妊娠前到妊娠后显著增加了 5.0°。然而，这些变化可能与妊娠状态无关，而是随时间而发生。这种曲线进展会导致身体自我形象不佳、腰痛和功能受限，无论妊娠状态如何。
