Characterization of the relationship between joint laxity and maternal hormones in pregnancy
Characterization of the relationship between joint laxity and maternal hormones in pregnancy
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DOI：
10.1016/s0029-7844(02)02447-x
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发表时间：
2003-02-01
影响因子：
7.2
通讯作者：
An, KN
中科院分区：
文献类型：
--
作者：
Marnach, ML;Ramin, KD;An, KN
目的：评估妊娠期间外周关节松弛情况，并将变化与血清皮质醇、雌二醇、黄体酮和松弛素联系起来。方法：46 名妊娠早期单胎妇女同意参加这项纵向观察性研究。使用临床测角仪进行双侧手腕松弛度测量（屈曲-伸展和内侧-外侧偏差），并在怀孕和产后的每个三个月期间测定皮质醇、雌二醇、黄体酮和松弛素的血清水平。还对患者的主观关节不适进行了筛查。统计分析包括学生 t 检验、方差分析和线性回归分析。结果：11 名女性 (24%) 在妊娠早期自发流产后被排除在研究之外。百分之五十四（35 人中的 19 人）表现出从妊娠早期到妊娠晚期任一手腕松弛程度增加（10% 或更高）。尽管皮质醇、雌二醇、黄体酮和松弛素的血清水平在怀孕期间显着升高，但在妊娠期间变得松弛的人和没有松弛的人之间，这些水平没有显着差异。腕关节松弛度与血清雌二醇、孕酮和松弛素水平的线性回归分析表明没有显着相关性。然而，手腕屈伸松弛度确实与母体皮质醇水平显着相关（r = 0.18，P = .03）。 57% 的女性在怀孕期间出现主观关节疼痛，这与关节松弛增加无关，但与雌二醇和黄体酮水平显着增加有关。结论：怀孕期间外周关节松弛增加；然而，这些变化与母体雌二醇、黄体酮或松弛素水平并没有很好的相关性。 (C) 2003 年，美国妇产科医师学会。
OBJECTIVE: To evaluate peripheral joint laxity during pregnancy and to correlate changes with serum cortisol, estradiol, progesterone, and relaxin.METHODS: Forty-six women with first-trimester singleton gestations consented to participate in this longitudinal observational study. Bilateral wrist laxity measurements (flexion-extension and medial-lateral deviation) were made using a clinical goniometer, and serum levels of cortisol, estradiol, progesterone, and relaxin were determined during each trimester of pregnancy and postpartum. Patients were also screened for subjective joint complaints. Statistical analysis included Student t test, analysis of variance, and linear regression analysis.RESULTS: Eleven women (24%) were excluded from the study after spontaneous first-trimester pregnancy loss. Fifty-four percent (19 of 35) demonstrated increased laxity (10% or higher) in either wrist from the first to the third trimester. Although serum levels of cortisol, estradiol, progesterone, and relaxin were significantly elevated during pregnancy, no significant differences in these levels were noted between those who became lax during gestation and those who did not. Linear regression analysis of wrist joint laxity and level of serum estradiol, progesterone, and relaxin demonstrated no significant correlation. Wrist flexion-extension laxity, however, did significantly correlate with level of maternal cortisol (r = 0.18, P = .03). Fifty-seven percent of women developed subjective joint pain during pregnancy, which was not associated with increased joint laxity, but was associated with significantly increased levels of estradiol and progesterone.CONCLUSION: Peripheral joint laxity increases during pregnancy; however, these changes do not correlate well with maternal estradiol, progesterone, or relaxin levels. (C) 2003 by The American College of Obstetricians and Gynecologists.