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Heredity of pregnancy-related pelvic girdle pain in Sweden

Kristiansson, Per ; Zöller, Bengt LU orcid ; Dahl, Niklas ; Kalliokoski, Paul ; Hallqvist, Johan and Li, Xinjun LU (2023) In Acta Obstetricia et Gynecologica Scandinavica 102(10). p.1250-1258
Abstract

Introduction: Pelvic girdle pain during and after pregnancy is a major public health problem with significant daily problems for affected women and their families. There is now accumulating evidence that pregnancy-related pelvic girdle pain originates from the sacroiliac joints and the pubic symphysis as well as their extra-articular ligaments. However, the heritability of the disease remains to be determined. We hypothesized that there is an increased familial risk of pregnancy-related pelvic girdle pain. Material and methods: A population-based national database linkage registry study of approximately 9.3 million individuals within 4.2 million families in Sweden with a recruitment period from 1997 to 2018. The Swedish Multi-generation... (More)

Introduction: Pelvic girdle pain during and after pregnancy is a major public health problem with significant daily problems for affected women and their families. There is now accumulating evidence that pregnancy-related pelvic girdle pain originates from the sacroiliac joints and the pubic symphysis as well as their extra-articular ligaments. However, the heritability of the disease remains to be determined. We hypothesized that there is an increased familial risk of pregnancy-related pelvic girdle pain. Material and methods: A population-based national database linkage registry study of approximately 9.3 million individuals within 4.2 million families in Sweden with a recruitment period from 1997 to 2018. The Swedish Multi-generation register was used to find female pairs of twins, full siblings, half-siblings and first cousins where both in the pairs had a completed pregnancy. The outcome measure was diagnosis of pregnancy-related pelvic girdle pain (International Classification of Diseases-10 O26.7 [1997–2018]) in the first pregnancy. Data was obtained from the Swedish Hospital Discharge Register, the Swedish Outpatient Care Register, the Swedish Medical Birth Register, the Primary Healthcare Register, and Medical Treatment Register. Cox regression analysis was used to calculate adjusted estimated effect of the exposure variable familial history of pregnancy-related pelvic girdle pain on the outcome variable pregnancy-related pelvic girdle pain at first birth. Results: From the registers, 1 010 064 women pregnant with their first child within 795 654 families were collected. In total, 109 147 women were diagnosed with pregnancy-related pelvic girdle pain. The adjusted hazard ratio for a familial risk of pregnancy-related pelvic girdle pain was 2.09 (95% CI 1.85–2.37) among twins (monozygotic and dizygotic), 1.78 (95% CI 1.74–1.82) in full siblings, 1.16 (95% CI 1.06–1.28) in half-siblings from the mother, 1.09 (95% CI 1.024–1.16) in half-siblings from the father and 1.09 (95% CI 1.07–1.12) in first cousins. Conclusions: This nationwide observational study showed a familial clustering of pregnancy-related pelvic girdle pain. The hazard ratio for the condition was associated with the degree of relatedness, suggesting that heredity factors contribute to the development of pregnancy-related pelvic girdle pain. There is no causal treatment available for pregnancy-related pelvic girdle pain and further studies are now encouraged to clarify the specific genetic factors that contribute to the disease and for future targeted interventions.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
heredity, pelvic girdle pain, pregnancy
in
Acta Obstetricia et Gynecologica Scandinavica
volume
102
issue
10
pages
1250 - 1258
publisher
Wiley-Blackwell
external identifiers
  • pmid:37470484
  • scopus:85165494534
ISSN
0001-6349
DOI
10.1111/aogs.14646
language
English
LU publication?
yes
id
00a78c9c-af74-4934-a5eb-a9b8b04680d7
date added to LUP
2023-09-19 14:39:00
date last changed
2024-04-19 01:07:41
@article{00a78c9c-af74-4934-a5eb-a9b8b04680d7,
  abstract     = {{<p>Introduction: Pelvic girdle pain during and after pregnancy is a major public health problem with significant daily problems for affected women and their families. There is now accumulating evidence that pregnancy-related pelvic girdle pain originates from the sacroiliac joints and the pubic symphysis as well as their extra-articular ligaments. However, the heritability of the disease remains to be determined. We hypothesized that there is an increased familial risk of pregnancy-related pelvic girdle pain. Material and methods: A population-based national database linkage registry study of approximately 9.3 million individuals within 4.2 million families in Sweden with a recruitment period from 1997 to 2018. The Swedish Multi-generation register was used to find female pairs of twins, full siblings, half-siblings and first cousins where both in the pairs had a completed pregnancy. The outcome measure was diagnosis of pregnancy-related pelvic girdle pain (International Classification of Diseases-10 O26.7 [1997–2018]) in the first pregnancy. Data was obtained from the Swedish Hospital Discharge Register, the Swedish Outpatient Care Register, the Swedish Medical Birth Register, the Primary Healthcare Register, and Medical Treatment Register. Cox regression analysis was used to calculate adjusted estimated effect of the exposure variable familial history of pregnancy-related pelvic girdle pain on the outcome variable pregnancy-related pelvic girdle pain at first birth. Results: From the registers, 1 010 064 women pregnant with their first child within 795 654 families were collected. In total, 109 147 women were diagnosed with pregnancy-related pelvic girdle pain. The adjusted hazard ratio for a familial risk of pregnancy-related pelvic girdle pain was 2.09 (95% CI 1.85–2.37) among twins (monozygotic and dizygotic), 1.78 (95% CI 1.74–1.82) in full siblings, 1.16 (95% CI 1.06–1.28) in half-siblings from the mother, 1.09 (95% CI 1.024–1.16) in half-siblings from the father and 1.09 (95% CI 1.07–1.12) in first cousins. Conclusions: This nationwide observational study showed a familial clustering of pregnancy-related pelvic girdle pain. The hazard ratio for the condition was associated with the degree of relatedness, suggesting that heredity factors contribute to the development of pregnancy-related pelvic girdle pain. There is no causal treatment available for pregnancy-related pelvic girdle pain and further studies are now encouraged to clarify the specific genetic factors that contribute to the disease and for future targeted interventions.</p>}},
  author       = {{Kristiansson, Per and Zöller, Bengt and Dahl, Niklas and Kalliokoski, Paul and Hallqvist, Johan and Li, Xinjun}},
  issn         = {{0001-6349}},
  keywords     = {{heredity; pelvic girdle pain; pregnancy}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1250--1258}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Obstetricia et Gynecologica Scandinavica}},
  title        = {{Heredity of pregnancy-related pelvic girdle pain in Sweden}},
  url          = {{http://dx.doi.org/10.1111/aogs.14646}},
  doi          = {{10.1111/aogs.14646}},
  volume       = {{102}},
  year         = {{2023}},
}