期刊论文详细信息
BMC Pregnancy and Childbirth
Finger joint laxity, number of previous pregnancies and pregnancy induced back pain in a cohort study
Per Kristiansson1  Anne Lindgren2 
[1] Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Unit, Uppsala University, SE-751 22 Uppsala, Sweden;Department of Physiotherapy, Sundsvall Hospital, SE-851 85 Sundsvall, Sweden
关键词: Postpartum;    Pregnancy;    Back pain;    Finger joint laxity;   
Others  :  1128525
DOI  :  10.1186/1471-2393-14-61
 received in 2013-05-30, accepted in 2014-01-29,  发布年份 2014
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【 摘 要 】

Background

General joint hypermobility is estimated to affect about 10% of the population and is a prerequisite of heritable connective tissue disorders where fragile connective tissue is a prominent feature. Pregnancy induced back pain is common whereas about 10% of women still have disabling pain several years after childbirth. The pathogenesis of the pain condition is uncertain, although several risk factors are suggested including general joint hypermobility. In the present study, the possible association of peripheral joint mobility in early pregnancy on the incidence of back pain with onset during pregnancy and persisting after childbirth was explored.

Methods

A cohort of 200 pregnant women recruited from antenatal health care clinics was assessed by questionnaire and clinical examination, including measurement of passive abduction of the left fourth finger, throughout pregnancy and at 13 weeks postpartum. Comparisons were made between women with and without back pain. Statistical tests used were χ2-test, t-test, Spearman correlation and multiple logistic regression.

Results

In the cohort, the mean passive abduction angle of the left fourth finger increased from 40.1° in early pregnancy to 41.8° at the postpartum appointment. At the postpartum appointment, women in the back pain group had a significantly larger mean passive abduction angle of the left fourth finger of 4.4°, twice as many previous pregnancies and deliveries, and more than twice as frequent back pain in previous pregnancy, as compared with women with no persistent back pain. A similar pattern was displayed in late pregnancy. In a multiple regression analysis, the passive abduction angle of the left fourth finger in early pregnancy and the number of previous pregnancies were positively, significantly and independently associated to the incidence of back pain in late pregnancy and postpartum.

Conclusions

Finger joint laxity as a reflection of constitutional weakness of connective tissue and number of previous pregnancies were associated with the development of back pain induced in pregnancy and persisting after childbirth. These factors may provide a foundation for development of targeted prevention strategies, but this have to be confirmed in future research including measurement of general joint laxity.

【 授权许可】

   
2014 Lindgren and Kristiansson; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Larsson LG, Baum J, Mudholkar GS, Srivastava DK: Hypermobility: prevalence and features in a Swedish population. Br J Rheumatol 1993, 32(2):116-119.
  • [2]Grahame R: Joint hypermobility and genetic collagen disorders: are they related? Arch Dis Child 1999, 80(2):188-191.
  • [3]Remvig L, Jensen DV, Ward RC: Epidemiology of general joint hypermobility and basis for the proposed criteria for benign joint hypermobility syndrome: review of the literature. J Rheumatol 2007, 34(4):804-809.
  • [4]De Paepe A, Malfait F: The Ehlers-Danlos syndrome, a disorder with many faces. Clin Genet 2012, 82(1):1-11.
  • [5]Miller BF, Hansen M, Olesen JL, Schwarz P, Babraj JA, Smith K, Rennie MJ, Kjaer M: Tendon collagen synthesis at rest and after exercise in women. J Appl Physiol 2007, 102(2):541-546.
  • [6]Garras DN, Carothers JT, Olson SA: Single-leg-stance (flamingo) radiographs to assess pelvic instability: how much motion is normal? J Bone Joint Surg Am 2008, 90(10):2114-2118.
  • [7]Calguneri M, Bird HA, Wright V: Changes in joint laxity occurring during pregnancy. Ann Rheum Dis 1982, 41(2):126-128.
  • [8]Schauberger CW, Rooney BL, Goldsmith L, Shenton D, Silva PD, Schaper A: Peripheral joint laxity increases in pregnancy but does not correlate with serum relaxin levels. Am J Obstet Gynecol 1996, 174(2):667-671.
  • [9]Bjelland E, Eskild E, Johansen R, Eberhard-Gran M: Pelvic Girdle Pain in Pregnancy: The Impact of Parity. Oslo: Norwegian Institute of Public Health; 2010.
  • [10]Bjelland EK, Kristiansson P, Nordeng H, Vangen S, Eberhard-Gran M: Hormonal contraception and pelvic girdle pain during pregnancy: a population study of 91 721 pregnancies in the Norwegian Mother and Child Cohort. Hum Reprod 2013, 28(11):3134-3140.
  • [11]Kumle M, Weiderpass E, Alsaker E, Lund E: Use of hormonal contraceptives and occurrence of pregnancy-related pelvic pain: a prospective cohort study in Norway. BMC Pregn Childbirth 2004, 4(1):11. BioMed Central Full Text
  • [12]Bjelland EK, Eberhard-Gran M, Nielsen CS, Eskild A: Age at menarche and pelvic girdle syndrome in pregnancy: a population study of 74 973 women. Bjog 2011, 118(13):1646-1652.
  • [13]Wijnhoven HA, de Vet HC, Smit HA, Picavet HS: Hormonal and reproductive factors are associated with chronic low back pain and chronic upper extremity pain in women--the MORGEN study. Spine (Phila Pa 1976) 2006, 31(13):1496-1502.
  • [14]Kristiansson P, Svardsudd K, von Schoultz B: Back pain during pregnancy: a prospective study. Spine (Phila Pa 1976) 1996, 21(6):702-709.
  • [15]Albert H, Godskesen M, Westergaard J: Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand 2001, 80(6):505-510.
  • [16]Svensson HO, Andersson GB, Johansson S, Wilhelmsson C, Vedin A: A retrospective study of low-back pain in 38- to 64-year-old women. Frequency of occurrence and impact on medical services. Spine (Phila Pa 1976) 1988, 13(5):548-552.
  • [17]Elden H, Lundgren I, Robertson E: Life’s pregnant puase of pain: Pregnant women’s experiences of pelvic girdle pain related to life: A Swedish interview study. Sex Reprod Health 2013, 4(1):29-34.
  • [18]Ostgaard HC, Andersson GB: Postpartum low-back pain. Spine (Phila Pa 1976) 1992, 17(1):53-55.
  • [19]Gutke A, Ostgaard HC, Oberg B: Predicting persistent pregnancy-related low back pain. Spine (Phila Pa 1976) 2008, 33(12):E386-E393.
  • [20]To WW, Wong MW: Factors associated with back pain symptoms in pregnancy and the persistence of pain 2 years after pregnancy. Acta Obstet Gynecol Scand 2003, 82(12):1086-1091.
  • [21]Olsson CB, Nilsson-Wikmar L, Grooten WJ: Determinants for lumbopelvic pain 6 months postpartum. Disabil Rehabil 2012, 34(5):416-422.
  • [22]Putschar WG: The structure of the human symphysis pubis with special consideration of parturition and its sequelae. Am J Phys Anthrop 1976, 45:589-594.
  • [23]Marnach ML, Ramin KD, Ramsey PS, Song SW, Stensland JJ, An KN: Characterization of the relationship between joint laxity and maternal hormones in pregnancy. Obstet Gynecol 2003, 101(2):331-335.
  • [24]Mogren IM: BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy. Eur Spine J 2006, 15(7):1093-1102.
  • [25]Carlsson AM: Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain 1983, 16(1):87-101.
  • [26]Salen BA, Spangfort EV, Nygren AL, Nordemar R: The Disability Rating Index: an instrument for the assessment of disability in clinical settings. J Clin Epidemiol 1994, 47(12):1423-1435.
  • [27]Ostgaard HC, Andersson GB, Schultz AB, Miller JA: Influence of some biomechanical factors on low-back pain in pregnancy. Spine (Phila Pa 1976) 1993, 18(1):61-65.
  • [28]Ostgaard HC: Back pain and pregnancy. Goteborg, Sweden: Goteborg University; 1991.
  • [29]Simmonds JV, Keer RJ: Hypermobility and the hypermobility syndrome. Man Ther 2007, 12(4):298-309.
  • [30]Kuo PH, Deshpande AD: Muscle-tendon units provide limited contributions to the passive stiffness of the index finger metacarpophalangeal joint. J Biomech 2012, 45(15):2531-2538.
  • [31]LeResche L, Sherman JJ, Huggins K, Saunders K, Mancl LA, Lentz G, Dworkin SF: Musculoskeletal orofacial pain and other signs and symptoms of temporomandibular disorders during pregnancy: a prospective study. J Orofac Pain 2005, 19(3):193-201.
  • [32]Bird HA, Brodie DA, Wright V: Quantification of joint laxity. Rheumatol Rehabil 1979, 18(3):161-166.
  • [33]Norton PA, Baker JE, Sharp HC, Warenski JC: Genitourinary prolapse and joint hypermobility in women. Obstet Gynecol 1995, 85(2):225-228.
  • [34]Soderberg MW, Falconer C, Bystrom B, Malmstrom A, Ekman G: Young women with genital prolapse have a low collagen concentration. Acta Obstet Gynecol Scand 2004, 83(12):1193-1198.
  • [35]Jobbins B, Bird H, Wrigth V: A joint hyperextensometer for the quantification of joint laxity. Eng Med 1979, 8:103-104.
  • [36]Sweetman BJ, Anderson JA, Dalton ER: The relationships between little-finger mobility, lumbar mobility, straight-leg raising, and low-back pain. Rheumatol Rehabil 1974, 13(4):161-166.
  • [37]Juul-Kristensen B, Rogind H, Jensen DV, Remvig L: Inter-examiner reproducibility of tests and criteria for generalized joint hypermobility and benign joint hypermobility syndrome. Rheumatology (Oxford) 2007, 46(12):1835-1841.
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