Ostensen M, Rugelsjøen A, Wigers S H
Centre for Mothers with Rheumatic Disease, University Hospital of Trondheim, Norway.
Scand J Rheumatol. 1997;26(5):355-60. doi: 10.3109/03009749709065698.
The fibromyalgia syndrome (FS) is a chronic pain disorder frequently affecting women of fertile age. However, the relationship of FS and pregnancy has been given little attention. In the present retrospective analysis, based on personal interviews, the influence on FS symptomatology by pregnancy, abortion, menstruation, use of oral contraceptives, and breast feeding was investigated. Twenty-six women with an established diagnosis of FS and a total of 40 pregnancies during disease were included in the study. With the exception of one patient, all women described worsening fibromyalgia symptoms during pregnancy with the last trimester experienced as the worst period. A new change of fibromyalgia symptoms within 6 months after delivery was reported for 37 of the 40 pregnancies, to the better in four and to the worse in 33 cases, resulting in a prolonged sick leave for 14 patients. An increase in depression and anxiety was a prominent problem in the post partum period. FS had no adverse effect on the outcome of pregnancy or the health of the neonate. In the majority of patients with FS, hormonal changes connected with abortion, use of hormonal contraceptives, and breast feeding did not modulate symptom severity. A pre-menstrual worsening of symptoms was recorded by 72% of the patients. Comparing the 26 patients who had borne children during disease with 18 patients who had all their children before the onset of FS revealed a negative effect of pregnancy and the post partum period of FS and increased functional impairment and disability in the 26 patients.
纤维肌痛综合征（FS）是一种慢性疼痛疾病，常影响育龄女性。然而，FS与妊娠之间的关系却很少受到关注。在本次回顾性分析中，通过个人访谈，研究了妊娠、流产、月经、口服避孕药的使用及母乳喂养对FS症状学的影响。该研究纳入了26例确诊为FS且在患病期间共有40次妊娠的女性。除1例患者外，所有女性均称妊娠期间纤维肌痛症状加重，其中妊娠晚期症状最为严重。40次妊娠中有37次报告在产后6个月内纤维肌痛症状有新变化，4例症状好转，33例症状恶化，14例患者因此延长了病假。产后抑郁和焦虑增加是一个突出问题。FS对妊娠结局或新生儿健康无不良影响。在大多数FS患者中，与流产、使用激素避孕药及母乳喂养相关的激素变化并未调节症状严重程度。72%的患者记录到经前症状加重。将26例在患病期间生育子女的患者与18例在FS发病前已育有所有子女的患者进行比较，发现妊娠及FS产后阶段对26例患者有负面影响，且功能障碍和残疾增加。
