Objective
This study is to clarify the relation between weight gain and the onset period of low back pain (LBP) during pregnancy. In addition, the article investigates the presence or absence of effective ways to manage LBP.
Patients and Methods
A sample of 117 post-partum women was recruited from a certain maternity clinic within Mie prefecture. All participants answered a questionnaire. By using 2006 MHLW (Ministry of Health, Labour and Welfare)'s recommended amount of weight during pregnancy as a reference, the samples were classified in 3 groups: insufficient when the amount of weight gain is below the MHLW recommendation, appropriate when the amount of weight gain is within the limit of recommendation, and excessive when the amount of weight gain is above the recommendation. Through the items in the questionnaire, we were able to obtain fundamental information regarding LBP. Data obtained was analyzed with relevancy among the three groups and LBP using chi-square tests by SPSS (version 21). Also, we performed one-way analysis of variance among three classified groups as for amount of weight, Breslow score.etc.
Results
1. Eighty two (70.7%) of the 116 included subjects had LBP in pregnancy. Among them, about 70% women suffered from LBP by third trimester pregnancy. Extra weight gain tends to cause early LBP.
2. More than 70% of all subjects experienced severe LBP period during third trimester pregnancy.
3. Within the three groups, the primary types of interference to basic actions and postures in daily life include “holding a crouching or standing position”, “holding or lifting up a heavy load”, “turning over in bed”, and “sitting for a long time”.
4. Techniques for reducing LBP include “using cushion or pillow”, “wearing a waist corset or pelvis belt”, “getting a massage”, “maternity swimming”, “applying a compress to the waist”, or “taking pain medication”. However, few women utilized the techniques, even though these techniques can be effective for all women suffering from LBP.
Conclusion/Discussion
The findings from this study show that when a woman gains a lot of weight, she is more likely to experience LBP early. In addition, those women tend to experience difficulties in simple movements of daily life during early stages of pregnancy. It is therefore necessary to provide proper health guidance in early stages to manage weight gain during pregnancy, to prevent LBP. Even though some treatments are effective, it is a fact that few women utilized them. Extensive information should be shared with everyone, especially health professionals and pregnant women. Given the significant impact on the quality of maternity life, health professionals need to be proactive in helping pregnant women to prevent LBP.
"},{"@language":"ja","@value":"目 的
妊娠期の体重増加と妊婦の腰痛発症時期との関連や腰痛への対処法及びその効果の有無の実態を明らかにする。
対象と方法
三重県内の某クリニックで出産された妊産婦を対象に質問紙調査を行った（117名に配布，有効回答率99.1%）。対象者を，厚生労働省（2006）による妊娠全期間をとおしての推奨体重増加量を参考に，妊娠中の体重増加量が，この目安未満であれば「不足群」，目安の範囲内であれば「適正群」，目安以上であれば「過剰群」と3群に分類した。質問紙の内容は，基本的属性，腰痛に関する項目とした。統計処理はSPSS（version21）を使用し，分類した3群と腰痛との関連についてはχ2検定を用い，「非妊時BMI」，「体重増加量」，「Breslow得点」などについてはそれぞれ一元配置分散分析を行った。
結 果
①腰痛発症率は70.7%で，そのうち，約7割の妊婦が妊娠末期までに腰痛を発症していた。過剰群ほど，腰痛発症時期は早い傾向にあった。
②腰痛が最も辛かった時期は，3群とも妊娠末期が70%以上であった。
③3群において，日常生活動作や姿勢への支障の程度が大きかったものは，「中腰姿勢または立位の保持」，「重量物の挙上または保持」，「寝返り」，「長時間の座位」であった。
④腰痛への対処法は，「枕やクッションの利用」，「コルセットやさらし（骨盤ベルト）の着用」，「マッサージ」の実施者が多く，「マタニティスイミング」や「湿布や鎮痛剤などの薬の使用」については実施者が少なかった。対処法の効果については，どの時期においてもすべての項目で，実施者の過半数に効果があった。
結 論
過剰群ほど腰痛発症時期は早い傾向にあり，日常生活動作への困難感を早期から抱いていると推測されたため，早期からの体重コントロールや腰痛への対処法に関する保健指導が重要である。効果があるにもかかわらず実施者が少ない対処法もあり，幅広く対処法について情報提供し，各々にあった対処法を妊娠生活の中に取り入れていけるように指導する必要性が示唆された。
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