Iguchi Tetsuhiro, Kakutani Kenichiro, Souda Hiroo, Kinoshita Keisuke, Funada Natsuko, Tomatsuri Masaki, Sadamitsu Takashi, Yurube Takashi
Department of Orthopedic Surgery, Saiseikai Hyogo Prefectural Hospital, 5-1-1 Fijiwaradai-nakamachi, Kobe, 651-1302, Japan.
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Eur Spine J. 2025 Jun 4. doi: 10.1007/s00586-025-08954-2.
To identify differences in severe pain levels during prepregnancy to four months postpartum among groups along with risk factors for residual pain early in pregnancy.
We examined 298 patients who participated in the questionnaire. Pain intensity was evaluated using a numerical rating scale (NRS) monthly postpartum. Four patterns emerged: recovery group (n = 200), with NRS 0-3 at 4 months postpartum; keep-high group (n = 20), with NRS ≥ 6 every month after delivery; worse group (n = 28), where NRS increased ≥ 3 during months 1-4; and mixed group (n = 50). Age, body mass index (BMI), history of back pain, breastfeeding, feeding posture, depression, and postpartum stress factors were compared.
Overall, 15% patients had pain with NRS ≥ 4 before pregnancy and 33% at 4 months postpartum. NRS score of the keep-high group was the highest (4.18) before pregnancy, with a distinctive pain pattern. For participants with NRS ≥ 4 before pregnancy, the odds ratio of NRS ≥ 7 in the final month was 5.56 [95% confidence interval: 2.52-12.58, p < 0.001]. All three groups compared with the recovery group demonstrated significant differences in the questionnaires for depression (p < 0.01) and postpartum stress factors (p < 0.05). The combination of lower back and back pain was an early indicator of severe postpartum pain.
Higher NRS scores before pregnancy and at multiple pain sites are early indicators of severe postpartum pain. All three groups, except the recovery group, showed a tendency for depression. However, the mixed group exhibited features similar to the recovery group.
确定孕前至产后四个月期间不同组间严重疼痛程度的差异以及妊娠早期残留疼痛的危险因素。
我们对298名参与问卷调查的患者进行了检查。产后每月使用数字评分量表（NRS）评估疼痛强度。出现了四种模式：恢复组（n = 200），产后4个月时NRS为0 - 3；持续高位组（n = 20），产后每月NRS≥6；恶化组（n = 28），在第1 - 4个月期间NRS增加≥3；以及混合组（n = 50）。比较了年龄、体重指数（BMI）、背痛史、母乳喂养、喂养姿势、抑郁和产后压力因素。
总体而言，15%的患者孕前疼痛时NRS≥4，产后4个月时为33%。持续高位组孕前NRS评分最高（4.18），具有独特的疼痛模式。对于孕前NRS≥4的参与者，最后一个月NRS≥7的优势比为5.56 [95%置信区间：2.52 - 12.58，p < 0.001]。与恢复组相比，所有三组在抑郁问卷（p < 0.01）和产后压力因素问卷（p < 0.05）方面均存在显著差异。下背部和背部疼痛的组合是严重产后疼痛的早期指标。
孕前较高的NRS评分和多个疼痛部位是严重产后疼痛的早期指标。除恢复组外，所有三组均有抑郁倾向。然而，混合组表现出与恢复组相似的特征。
