Citation: | WU Xueqin, JIN Rong, CAO Xia. Construction of nomogram model for predicting risk of maternal postpartum chronic low back pain[J]. Journal of Clinical Medicine in Practice, 2023, 27(16): 121-126. DOI: 10.7619/jcmp.20231835 |
To construct a predictive model for postpartum chronic low back pain and verify its prediction effect.
A total of 450 pregnant women who gave birth were selected as research objects and divided into modeling group (315 cases) and verification group (135 cases) on the basis of a ratio of 7 to 3. According to the occurrence of chronic low back pain after delivery, the modeling group was divided into pain group (n=105) and no pain group (n=210). Single factor and multiple factor Logistic regression analysis were used to screen the risk factors affecting the occurrence of postpartum chronic low back pain, and a nomogram model was drawn to predict the risk of postpartum chronic low back pain.
Among the 15 pregnant women, 105 had chronic low back pain after delivery, and the incidence was 33.33%. Multivariate Logistic regression analysis showed that fetal body weight ≥4 kg (OR=2.585), the number of births ≥3 times (OR=6.144), mode of delivery was caesarean section (OR=2.015), the mother as the main caregiver of the baby (OR=2.390), a history of low back pain during pregnancy (OR=1.942) and had spinal anesthesia (OR=2.223) were independent risk factors for postpartum chronic low back pain (P < 0.05). Based on the above risk factors, a nomogram model was established to predict the risk of postpartum chronic low back pain, and the internal and external verification was carried out. The results showed that the predicted risk of postpartum chronic low back pain was basically consistent with the actual risk; receiver operating characteristic (ROC) curve analysis results showed that the area under the curve of the predictive models in the modeling group and the verification group to predict postpartum chronic low back pain was 0.803 (95%CI, 0.754 to 0.845) and 0.802 (95%CI, 0.725 to 0.866), respectively, indicating that the prediction model had good prediction ability.
Fetal body weight ≥4 kg, the number of births ≥3 times, delivery mode of caesarean section, the mother being the primary caregiver of the baby, history of low back pain during pregnancy and intraspinal anesthesia are risk factors affecting the occurrence of postpartum chronic low back pain. The prediction model based on the above risk factors can accurately evaluate the risk of chronic low back pain in postpartum women, with good differentiation and effectiveness.
[1] |
何青, 石霖, 侯志雷. 针对自然分娩和剖宫产发生产后腰背痛的差异及相关因素分析[J]. 中国科技期刊数据库科研, 2021(4): 75-76. https://www.cnki.com.cn/Article/CJFDTOTAL-SWCX201715037.htm
|
[2] |
TAVARES P, BARRETT J, HOGG-JOHNSON S, et al. Prevalence of low back pain, pelvic girdle pain, and combination pain in a postpartum Ontario population[J]. J D'obstetrique Gynecol Du Can, 2020, 42(4): 473-480. doi: 10.1016/j.jogc.2019.08.030
|
[3] |
谢芳, 李金容, 张彩霞. 产后抑郁影响因素的多元Logistic回归分析[J]. 中国计划生育和妇产科, 2020, 12(7): 93-96. doi: 10.3969/j.issn.1674-4020.2020.07.24
|
[4] |
蔡大军, 王冰, 任强. 初产产妇分娩后慢性腰背痛与抑郁症的关联性研究[J]. 颈腰痛杂志, 2019, 40(5): 666-668. doi: 10.3969/j.issn.1005-7234.2019.05.029
|
[5] |
姜雄春, 凌静, 陆春秀, 等. 初产妇产后腰背痛现状及其风险因素分析[J]. 广西医科大学学报, 2021, 38(4): 833-836. doi: 10.16190/j.cnki.45-1211/r.2021.04.035
|
[6] |
SNOW S, KIRWAN J R. Visual analogue scales: a source of error[J]. Ann Rheum Dis, 1988, 47(6): 526. doi: 10.1136/ard.47.6.526
|
[7] |
冯喆, 朱秋静, 胡涛, 等. 产后腰痛社区康复模式初探[J]. 浙江中西医结合杂志, 2022, 32(8): 719-721. doi: 10.3969/j.issn.1005-4561.2022.08.008
|
[8] |
吴静芬, 阙云端. 核心稳定性训练治疗产后腰背痛32例疗效分析[J]. 山西医药杂志, 2019, 48(12): 1432-1433. doi: 10.3969/j.issn.0253-9926.2019.12.013
|
[9] |
关应军, 徐世元, 陈业松, 等. 产妇产后慢性腰背痛发病率和风险因素[J]. 中国医师进修杂志, 2015, 38(6): 432-434, 439. doi: 10.3760/cma.j.issn.1673-4904.2015.06.013
|
[10] |
TAKEGATA M, HARUNA M, MATSUZAKI M, et al. Aetiological relationships between factors associated with postnatal traumatic symptoms among Japanese primiparas and multiparas: a longitudinal study[J]. Midwifery, 2017, 44: 14-23. doi: 10.1016/j.midw.2016.10.008
|
[11] |
周成芬, 黄利. 剖宫产术后中医护理应用及其对盆膈裂孔参数、感染率和应激指标的影响[J]. 西部中医药, 2021, 34(1): 118-121. https://www.cnki.com.cn/Article/CJFDTOTAL-GSZY202101031.htm
|
[12] |
徐凤周, 辛英, 范金鹏, 等. 初产妇产后持续腰痛的影响因素分析[J]. 颈腰痛杂志, 2020, 41(4): 445-447, 451. doi: 10.3969/j.issn.1005-7234.2020.04.019
|
[13] |
WIEZER M, HAGE-FRANSEN M A H, OTTO A, et al. Risk factors for pelvic girdle pain postpartum and pregnancy related low back pain postpartum; a systematic review and meta-analysis[J]. Musculoskelet Sci Pract, 2020, 48: 102154. doi: 10.1016/j.msksp.2020.102154
|
[14] |
秦丹, 国松, 王英男. 产后腰背痛与孕妇分娩方式和麻醉方法等因素的关系[J]. 医学临床研究, 2018, 35(4): 780-782. doi: 10.3969/j.issn.1671-7171.2018.04.055
|
[15] |
姜雄春, 凌静, 杨一兰. 分娩方式对初产妇产后腰背痛的影响研究[J]. 广西医科大学学报, 2021, 38(6): 1182-1186. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYD202106019.htm
|
[16] |
徐玲, 杨丽. 产后慢性腰痛的危险因素及运动康复方案干预效果分析[J]. 中国妇幼保健, 2020, 35(14): 2692-2694. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202014049.htm
|
[17] |
万权, 李辉, 章勇, 等. 椎管内麻醉后腰腿痛42例原因分析与对策[J]. 中国疼痛医学杂志, 2016, 22(7): 548-550. https://www.cnki.com.cn/Article/CJFDTOTAL-ZTYZ201607020.htm
|