Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2021; 9(1): 91-101
Published online Jan 6, 2021. doi: 10.12998/wjcc.v9.i1.91
Role of relaxin in diastasis of the pubic symphysis peripartum
Yan Wang, Yong-Qiang Li, Mei-Rong Tian, Nan Wang, Zun-Cheng Zheng
Yan Wang, Rehabilitation Medicine, Taian City Central Hospital, Taian 271000, Shandong Province, China
Yong-Qiang Li, Department of Otolaryngology, Taian City Central Hospital, Taian 271000, Shandong Province, China
Mei-Rong Tian, Department of Obstetrics, Taian City Central Hospital, Taian 271000, Shandong Province, China
Nan Wang, Rehabilitation Centre, Qingdao Fuwai Cardiovascular Hospital, Qingdao 266034, Shandong Province, China
Zun-Cheng Zheng, Department of Rehabilitation, Taian City Central Hospital, Taian 271000, Shandong Province, China
Author contributions: Zheng ZC designed the study, supervised the study performance, and revised the manuscript; Wang Y developed the project and participated in the acquisition, analysis, and interpretation of the data; Li YQ, Tian MR and Wang N analyzed the data, drafted the manuscript, and critically revised the manuscript for intellectual content.
Supported by The Science and Technology Development Plan of Taian, No. 2018NS0203.
Institutional review board statement: The study protocol was reviewed and approved by the Ethics Committee of Taian City Central Hospital.
Informed consent statement: All study participants, or their legal guardians, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zun-Cheng Zheng, MAMS, Chief Doctor, Director, Professor, Department of Rehabilitation, Taian City Central Hospital, No. 29 Longtan Road, Taian 271000, Shandong Province, China. zhengzc1965@126.com
Received: June 15, 2020
Peer-review started: June 15, 2020
First decision: September 13, 2020
Revised: October 10, 2020
Accepted: November 13, 2020
Article in press: November 13, 2020
Published online: January 6, 2021
ARTICLE HIGHLIGHTS
Research background

Although the incidence of postpartum pubic symphysis separation is not high, the pain and mobility disorders caused by it seriously affect the quality of life of women. However, current research has not elucidated the etiology and treatment of this disease. The purpose of this study was to determine whether increased relaxin (RLX) levels were a risk factor for pubic symphysis separation, and whether other factors were involved.

Research motivation

To study the association between RLX and peripartum pubic symphysis separation, and to evaluate other factors that might affect this association. In the future, we hope to predict the risk of pubic symphysis diastasis by determining RLX levels and controlling the possible factors involved, in order to reduce the incidence of postpartum pubic symphysis separation.

Research objectives

We studied the relationships between RLX levels/other factors and the occurrence of pubic symphysis separation, and determined that maternal RLX levels and neonatal weight were risk factors for symphysis pubis separation. This information can be used to guide clinical judgment on the risk of pubic symphysis separation, and thereby reduce its incidence.

Research methods

We performed a cross-sectional study on pregnant women between April 2019 and January 2020. Baseline demographic characteristics, including gestational age, weight, neonatal weight, delivery mode and duration of the first and second stages of labor, were recorded, as well as the pubic symphysis separation, maternal capability for daily life activities, and pain scores. Several statistical methods were used to analyze the data. Previous studies did not include as many factors as we have shown herein, and investigators did not conduct comparative studies.

Research results

In the present study, it was found that RLX levels and neonatal weight were risk factors for peripartum separation of the pubic symphysis. We wished to determine the possible pathogenic factors leading to symphysis pubis separation; however, the sample size of our study was not large, and further research is needed.

Research conclusions

Serum RLX levels and neonatal weight were associated with the occurrence, but not the severity, of peripartum pubic symphysis separation.

Research perspectives

In our future studies, we will expand the sample size to further explore the role of RLX levels in peripartum pubic symphysis separation. We will also continue to observe the significant changes in RLX levels in peripartum pubic symphysis separation and subsequent healing.