Population based case-control study of sick leave in postmenopausal women before diagnosis of hyperparathyroidism

OBJECTIVE: To analyse sick leave in women at risk of primary hyperparathyroidism before its diagnosis. DESIGN: Case-control study nested within a screened cohort of postmenopausal women. Cases were women with hyperparathyroidism without prior knowledge of their disease and no traditional symptoms or complications. Controls were women from the screened population without hyperparathyroidism. SETTING: Population based screening within a Swedish community. SUBJECT: 48 case-control pairs of women aged 55-70 years. MAIN OUTCOME MEASURE: Sick leave during the 5 years before diagnosis. RESULTS: Total duration of sickness benefits was longer in the cases than controls, and this discrepancy included sick leave on full time or half time and for periods of longer than a week. Cases had an increased risk of sick leave more than half of the investigated time compared with controls (odds ratio 12). Doctors' certificates showed that the overrepresented sick leave in the cases related mainly to cardiovascular diseases. CONCLUSION: Asymptomatic mild primary hyperparathyroidism in postmenopausal women is accompanied by a previously unrecognised morbidity, which has consequences for clinical management of the disorder and its impact on the health economy.     

Patients with low back pain not returning to work. A 12-month follow-up study

STUDY DESIGN: A prospective study of patients treated with a light mobilization program for long-term low back pain. OBJECTIVES: To examine whether medical, psychological, or social factors predict failure to return to work within 12 months in the Scandinavian system of compulsory workers' compensation and social insurance, after a light mobilization program administered 8-12 weeks after initial sick leave. SUMMARY OF BACKGROUND DATA: The relative power of predicting factors varies in previous work, and there are no previous data on prognostic factors for light mobilization programs. METHOD: Patients (n = 260) on sick leave for 8-12 weeks for low back pain were examined with a battery of psychological and medical tests, before entering a light mobilization program. The treatment was given regardless of radiographic or clinical findings. The patients were encouraged to be active participants in the management and prevention of their back pain. Their sick leave status then was checked through registers 12 months after they had entered the treatment program. RESULTS: For those not returning to work within 12 months (23%), only combined models had acceptable predictive power (77%; discriminant analyses). Dominant variables were low Internal Health Locus of Control Score, restricted lateral mobility, and reduced work ability. The predictive value of each set of variables, taken alone, was significant only for medical variables (67% correct prediction). CONCLUSIONS: The final discriminant function may have potential as a brief screening instrument for the number of patients with low back pain who do not benefit from the light mobilization program.     

Pain pattern in pregnancy and "catching" of the leg in pregnant women with posterior pelvic pain

STUDY DESIGN: A cross-sectional study of symptoms and signs in pregnant women. OBJECTIVES: To describe the clinical appearance of back pain in pregnancy and the relation between pain distribution and symptoms in women with posterior pelvic pain, in order to shed light on etiologic factors. SUMMARY OF BACKGROUND DATA: Back pain is common in the general population. During pregnancy, it is even more common, and back pain is experienced by about 50% of pregnant women. In the pregnant woman, differentiation between common low back pain and posterior pelvic pain is believed to be essential because these symptoms should be treated in different ways. METHODS: The women were interviewed with a questionnaire. Those with back symptoms completed a pain drawing and were examined by an orthopedic surgeon. Based on the symptoms and findings, the women were divided into three groups: thoracic pain, lumbar pain, and posterior pelvic pain. RESULTS: Of 335 pregnant women, 51% had back pain at the time of examination. The pain was more widespread compared with common low back pain. Seventy-one percent of the 171 patients examined by the orthopedic surgeon had a positive posterior pelvic pain test. These women more often had pain in the gluteal and posterior thigh regions. A "catching" feeling of the leg was described when walking by 44 of 122 these women, whereas only 1 of 49 women without a posterior pelvic pain test had such symptoms. CONCLUSIONS: The higher prevalence of back pain in pregnancy may be due to several factors. In women with posterior pelvic pain, there is a specific symptom-a catching of the leg when walking. The most probable explanation for the catching is that local nociception disturbs muscular function in women with posterior pelvic pain because changes in the sacroiliac joint range of motion, which is very small, cannot cause this symptom.     

Lumbar supports and education for the prevention of low back pain in industry: a randomized controlled trial

CONTEXT: Low back pain is a frequent and costly health problem. Prevention of low back pain is important both for the individual patient and from an economic perspective. OBJECTIVE: To assess the efficacy of lumbar supports and education in the prevention of low back pain in industry. DESIGN: A randomized controlled trial with a factorial design. SETTING: The cargo department of an airline company in the Netherlands. PARTICIPANTS: A total of 312 workers were randomized, of whom 282 were available for the 6-month follow-up. INTERVENTIONS: Subjects were randomly assigned to 4 groups: (1) education (lifting instructions) and lumbar support, (2) education, (3) lumbar support, and (4) no intervention. Education consisted of 3 group sessions on lifting techniques with a total duration of 5 hours. Lumbar supports were recommended to be used during working hours for 6 months. MAIN OUTCOME MEASURES: Low back pain incidence and sick leave because of back pain during the 6-month intervention period. RESULTS: Compliance with wearing the lumbar support at least half the time was 43%. In the 282 subjects for whom data were available, no statistically significant differences in back pain incidence (48 [36%] of 134 with lumbar support vs 51 [34%] of 148 without, P=.81) or in sick leave because of low back pain (mean, 0.4 days per month with lumbar support vs 0.4 days without, P=.52) were found among the intervention groups. In a subgroup of subjects with low back pain at baseline, lumbar supports reduced the number of days with low back pain per month (median, 1.2 vs 6.5 days per month; P=.03). CONCLUSIONS: Overall, lumbar supports or education did not lead to a reduction in low back pain incidence or sick leave. The results of the subgroup analysis need to be confirmed by future research. Based on our results, the use of education or lumbar supports cannot be recommended in the prevention of low back pain in industry.     

Spontaneous recovery of impaired memory span: does comprehension recover?

Low back pain is common during pregnancy and is of moderate or severe intensity in about one fourth of all pregnancies. The etiology is multifactorial but in most cases is related to the physical and physiologic changes brought about by pregnancy. For most women, the pain resolves spontaneously, although they remain at higher risk for increased LBP in future pregnancies and for the development of symptomatic disc disease in later life. Many of the common treatments for LBP are contraindicated or must be modified in this setting. Neurologically symptomatic herniated discs are rare during pregnancy, yet, when indicated, pregnant women can safely undergo surgery.     

Back pain in relation to pregnancy: a 6-year follow-up

STUDY DESIGN: A prospective randomized controlled 6-year follow-up study of women with back pain during pregnancy. OBJECTIVES: To describe the long-term development of back pain in relation to pregnancy and to identify the effects of a physiotherapy and patient education program attended during pregnancy. SUMMARY OF BACKGROUND DATA: Pain incidence and intensity during pregnancy can be reduced by physiotherapy. No study has described the development of pain experienced for a period of years after delivery or the long-term effect of physiotherapy. METHODS: Pregnant women, registered consecutively, were randomly assigned to one control group and to two intervention groups and were observed throughout pregnancy, with follow-up after 3 months and 6 years. RESULTS: The first phase of the study was completed by 362 women. After 3 months, 351 and after 6 years, 303 women had been observed. Back pain among 18% of all women before pregnancy and among 71% during pregnancy declined to 16% after 6 years. Pain intensity was highest in Week 36 (visual analog score, 5.4) and declined markedly 6 years later (visual analog score, 2.5). Slow regression of pain after partus correlated with having a back pain history before pregnancy, (r = 0.30; P < 0.05), with high pain intensity during pregnancy (r = 0.45; P < 0.01), and with much residual pain 3 months after pregnancy (r = 0.41; P < 0.01). These correlations were not found in the intervention groups. Furthermore, frequency of back pain attacks at 6 years correlated with frequency of attacks during pregnancy (r = 0.41; P < 0.01) and with a vocational factor (r = -0.25; P < 0.01). Physiotherapy and patient education had no effects on back pain development among women without pain during pregnancy. CONCLUSIONS: Back pain during pregnancy regressed spontaneously soon after delivery and improved in few women later than 6 months post partum. Expected correlations between back pain in relation to pregnancy and back pain 6 years later were not present in the intervention groups who had attended a physiotherapy and education program during pregnancy. The program had no prophylactic effects on women without back or pelvic pain during pregnancy.     

Efficiency and costs of medical exercise therapy, conventional physiotherapy, and self-exercise in patients with chronic low back pain. A pragmatic, randomized, single-blinded, controlled trial with 1-year follow-up

STUDY DESIGN: A multicenter, randomized, single-blinded controlled trial with 1-year follow-up. OBJECTIVES: To evaluate the efficiency of progressively graded medical exercise therapy, conventional physiotherapy, and self-exercise by walking in patients with chronic low back pain. SUMMARY AND BACKGROUND DATA: Varieties of medical exercise therapy and conventional physiotherapy are considered to reduce symptoms, improve function, and decrease sickness absence, but this opinion is controversial. METHODS: Patients with chronic low back pain or radicular pain sick-listed for more than 8 weeks and less than 52 weeks (Sickness Certificate II) were included. The treatment lasted 3 months (36 treatments). Pain intensity, functional ability, patient satisfaction, return to work, number of days on sick leave, and costs were recorded. RESULTS: Of the 208 patients included in this study, 71 were randomly assigned to medical exercise therapy, 67 to conventional physiotherapy, and 70 to self-exercise. Thirty-three (15.8%) patients dropped out during the treatment period. No difference was observed between the medical exercise therapy and conventional physiotherapy groups, but both were significantly better than self-exercise group. Patient satisfaction was highest for medical exercise therapy. Return to work rates were equal for all 3 intervention groups at assessment 15 months after therapy was started, with 123 patients were back to work. In terms of costs for days on sick leave, the medical exercise therapy group saved 906,732 Norwegian Kroner (NOK) ($122,531.00), and the conventional physiotherapy group saved NOK 1,882,560 ($254,200.00), compared with the self-exercise group. CONCLUSIONS: The efficiency of medical exercise therapy and conventional physiotherapy is shown. Leaving patients with chronic low back pain untampered poses a risk of worsening the disability, resulting in longer periods of sick leave.     

Five-year follow-up study of a controlled clinical trial using light mobilization and an informative approach to low back pain

STUDY DESIGN: A controlled clinical trial. OBJECTIVES: To examine the long-term effect of an informative approach to low back pain. SUMMARY OF BACKGROUND DATA: In management and prevention of low back pain, back school based on an ergonomic approach have played in important role. The effect of such informative interventions is not clear. METHODS: A 5-year follow-up study was done on patients included in a previous study. The outcome was measured by return to work or still on sick leave. The patients were allocated to an intervention group (n = 245) and a control group (n = 244). Only the intervention group was called in for examination and intervention and answered a battery of tests for psychological and health factors. The intervention apart from the clinical examination consisted of education in an "mini back school." The program was based on a new medical model for low back pain. RESULTS: Forty-seven (19%) of the patients in the intervention group, compared with 84 patients (34%) in the control group, were still on sick leave after 5 years (P < 0.001). There were fewer recurrences of sick leave (P < 0.03) in the intervention group than in the control group. Based on Internal Health Locus of Control, number of children, and income, 75% were correctly classified as nonreturners in the intervention group. CONCLUSIONS: This study indicates that subchronic low back pain may be managed successfully with an approach that includes clinical examination combined with information for patients about the nature of the problem, provided in a manner designed to reduce fear and give them reason to resume light activity.     

Can it be predicted which patients with chronic low back pain should be offered tertiary rehabilitation in a functional restoration program? A search for demographic, socioeconomic, and physical predictors

STUDY DESIGN: A prospective clinical trial was conducted that involved six groups of patients with chronic low back pain selected from a large cohort (N = 816). OBJECTIVES: To correlate pretreatment baseline variables with outcome parameters after treatment in a functional restoration program or in control programs, to identify possible factors predictive of the need for functional restoration. SUMMARY OF BACKGROUND DATA: Since the functional restoration program was first described, research has focused on identifying patients who will or will not benefit from such a program. The value of previous studies is limited, however, because predictive factors from a control group were not "subtracted." METHODS: Eight hundred sixteen patients with chronic low back disability were included. All had a structured medical examination, including various physical tests before participation in either a functional restoration program (n = 621) or shorter "control" outpatient programs (n = 144). A smaller group of the cohort (n = 51) had no treatment and served as a pure control group. Six groups were selected from the cohort: Three underwent an identical functional restoration program and three underwent different outpatient control programs. Several baseline demographic, physical, and socioeconomic variables were correlated to 1-year outcome parameters. RESULTS: Age, days of sick leave, connection to the work force, and back pain intensity, were significantly correlated to success 1 year after entry into the study in all groups, no matter what kind of treatment was administered. Back muscle endurance, sports activity, activity of daily living scores, and vibrations were of importance in some outcome parameters for success after functional restoration. Smoking was positively correlated to disability pension. Days of sick leave and, in functional restoration, ability to work were the only factors that were correlative with statistics for people who withdrew. CONCLUSIONS: Different factors can be identified as predictive of outcome in a functional restoration program, but most of these factors were also shown to predict success for shorter control outpatient programs or of no treatment.     

Early pregnancy termination with mifepristone and misoprostol in the United States

BACKGROUND: Mifepristone and a prostaglandin have been used successfully to terminate pregnancy in Europe and China. We report the results of a large U.S. study of mifepristone and misoprostol in women with pregnancies of up to nine weeks' duration. METHODS: We administered 600 mg of mifepristone and then 400 microg of misoprostol two days later to 2121 women seeking termination of their pregnancies at 17 centers. The women were observed for four hours after the administration of misoprostol and returned on day 15 for final assessment. RESULTS: Two thousand fifteen women completed the final assessment. Among them, pregnancy was terminated in 762 of the 827 women pregnant for < or =49 days (92 percent), 563 of the 678 women pregnant for 50 to 56 days (83 percent), and 395 of the 510 women pregnant for 57 to 63 days (77 percent) (P<0.001). Termination occurred within 4 hours after the administration of misoprostol in 49 percent of the women and within 24 hours in 75 percent. Failures, defined as cases requiring surgical intervention for medical reasons or because the patient requested it, the abortion was incomplete, or the pregnancy was ongoing, increased with increasing duration of pregnancy. The largest increase was in failures representing ongoing pregnancy, which increased from 1 percent in the < or =49-days group to 9 percent in the 57-to-63-days group (P<0.001). Abdominal pain, nausea, vomiting, diarrhea, and vaginal bleeding also increased with advancing gestational age. Two percent of the women in the < or =49-days group, as compared with 4 percent in each of the other two groups, were hospitalized, underwent surgical interventions, and received intravenous fluids (P=0.008). CONCLUSIONS: This mifepristone-misoprostol regimen is effective in terminating pregnancies, especially in women with pregnancies of 49 days' duration or less.     

Changes in energy intakes during pregnancy and lactation in a national sample of US women

Increases in energy intakes during pregnancy and lactation were evaluated by examining dietary data for 458 pregnant women who participated in the Continuing Surveys of Food Intakes by Individuals conducted in 1985 and 1986. Energy intakes were well below recommendations during all reproductive states; however, increases during pregnancy approximated recommendations, while increases during lactation were low. Postpartum non-lactating intakes did not return to prepregnancy levels for Black women or women with lower incomes.     

The risk of prematurity and small-for-gestational-age birth in Mexico City: the effects of working conditions and antenatal leave

OBJECTIVES: This study examined the effect of working conditions, occupational stress, and antenatal leave on risk of small-for-gestational age and premature births in Mexico City. METHODS: Over a 3-month period, 2663 (96.2%) of 2767 women who gave birth at three major hospitals and worked at least 3 months during pregnancy were interviewed shortly after delivery. After the exclusion of multiple gestations and birth defects, 261 (10.0%) small-for-gestational-age and 288 (11.0%) preterm births were identified. RESULTS: For small-for-gestational-age births, working more than 50 hours a week (odds ratio [OR] = 1.59), standing more than 7 hours a day (OR = 1.40), and no antenatal leave (OR = 1.55) were associated with an increased risk. Women with no antenatal leave were also much more likely to give birth prematurely (OR = 3.04). CONCLUSIONS: In this study, arduous working conditions and lack of antenatal leave benefits were found to increase the risk of poor birth outcome in Mexican women. Enforcement of existing antenatal leave laws and provision of comparable benefits for the uninsured may reduce the incidence of small-for-gestational-age births and prematurity.     

Effect of blood viscosity on the function of isolated perfused porcine kidney after cold preservation

STUDY DESIGN: Cross-sectional study with two age cohorts. OBJECTIVE: To assess whether women receiving hormone replacement therapy after menopause have a higher prevalence of back problems than women who do not receive such treatment. BACKGROUND: Back pain is a common medical problem throughout life and especially during pregnancy. Hormonal factors have been proposed as a possible contributor. PATIENTS AND METHODS: A validated postal questionnaire was sent in early 1995 to all 1324 women of 55 years and 56 years of age residing in Link?ping, Sweden. This questionnaire included questions about current hormone replacement treatment, previous and current back problems, medical care for back problems, parity, exercise and smoking habits, and occupation. RESULTS: The questionnaire was returned by 84.7% of the women. There was a significant, albeit weak, positive association between current use of hormone replacement treatment and low back pain. Previous back problems during pregnancy was a strong risk factor for current back pain, whereas neither current smoking nor regular physical exercise was a risk factor according to multiple logistic regression analysis. The interaction of smoking and an occupation involving heavy lifting significantly affected back pain. CONCLUSIONS: Women receiving hormone replacement treatment had a slightly, but significantly, higher prevalence of current back pain than nonusers (48% vs. 42%, respectively, P < 0.05), which could not be explained by differences in occupation, smoking habits, or current physical activity. Although the association between hormone replacement therapy and back problems is weak and probably of minor clinical importance, it is speculated that hormonal effects on joints and ligaments may be involved.     

Pregnancies of women with epilepsy: a population-based study in Iceland

PURPOSE: Women with epilepsy who become pregnant are commonly considered to be at high risk for complications during pregnancy or delivery. The offspring are also considered to have increased risk of perinatal mortality, congenital malformations, and maturational delay. Because few of these studies are population based, potential bias exists because of selection. METHODS: We performed a historical population-based cohort study in Iceland to determine the prevalence of epilepsy among pregnant women, to identify pregnancy and delivery complications in women with epilepsy, and to determine the outcome of their pregnancies as compared with that in the general population of Iceland. We identified all women with active epilepsy who gave birth during a 19-year period in Iceland. RESULTS: In this population, 3.3 in 1,000 pregnancies involve mothers with active epilepsy. The frequency of adverse events (AE) during pregnancy in the women with epilepsy is similar to that observed among all live births in the population, but cesarean section was performed twice as frequently as in the general population. Perinatal mortality rate and mean birth weight are not significantly different in the offspring of women with epilepsy as compared with rest of the population. The risk of major congenital malformations (MGM) is increased 2.7-fold over that expected when a mother is treated with antiepileptic drugs (AEDs) during a pregnancy. CONCLUSIONS: Our study indicates that the rate of complications of pregnancy in mothers with active epilepsy is low and similar to that of the general population with epilepsy. Use of AEDs by the mother during pregnancy significantly increases the risk of MGM in the offspring.     

Women with little or no prenatal care during pregnancy. Results of a study of twenty departments

OBJECTIVES: To estimate the frequency of women who have little or no health care during pregnancy, to assess associated perinatal risk, and to identify the corresponding risk factors. METHODS: Women who consulted less than 4 times or who began consultation during the third trimester were identified in public and private maternity units in 20 French departments. These women were compared with a sample of women from the same institutions who consulted regularly. RESULTS: The percentage of pregnant women with little or no care was 1.1%. Risk of premature birth was increased 4-fold compared with women who consulted regularly. Women who consulted little were very young, multiparous or living alone with no health care insurance. These women stated that the reason for not consulting was that their pregnancy was not accepted, financial difficulties and administrative problems. CONCLUSION: The lack of regular medical care results from social obstacles, especially in foreign born women but is also related to personal problems which are difficult to identify and manage.     

Prolonged sick-leave: the role of general practitioner

The aim was to study why long sick leave benefit cases had taken a long time with special focus on the communication between the general practitioner and the social service department. An explorative study was made of the development and communication in 27 consecutive lengthy sick leave cases that had lasted more than 13 weeks, that were discussed at three audit panels with participation of the social worker/officer in charge, the general practitioner and the representatives from the local hospital. The study took place in Aarhus County in 1994. The results were that many of the same problems were found in various cases, such as insufficient certificates, inappropriate use of benefit certificates, waiting times for examinations, treatment and especially rehabilitation. In the more complicated cases, of which there were many, a coordinating person would have helped matters. The GP's were willing to take on this role. The main reasons for lengthy benefit cases were that the illness was medically complicated and of a long duration.     

Urinary tract infections and pregnancy in women who underwent antireflux surgery in childhood

PURPOSE: For several decades ureteroneocystostomy has been performed in children to correct primary vesicoureteral reflux. A purported indication for antireflux surgery is to prevent significant upper urinary tract infection during pregnancy. We performed a long-term followup of women who underwent antireflux surgery during childhood to determine outcome in regard to urinary tract infection history and pregnancy. MATERIALS AND METHODS: We identified 227 women of childbearing age who underwent ureteral reimplantation for primary vesicoureteral reflux from 1964 through 1981. Of the 122 women contacted 41 had been pregnant (77 total pregnancies). Cystitis or asymptomatic bacteriuria and pyelonephritis developed during 18 and 5 pregnancies, respectively. The 77 pregnancies resulted in 57 term births, 7 voluntary pregnancy interruptions and 13 spontaneous abortions. RESULTS: Patients who previously underwent successful antireflux surgery continued to have a significant number of urinary tract infections through the intervening years. Despite a higher than expected incidence of pyelonephritis, they had relatively little hypertension and renal insufficiency. During pregnancy the incidence of pyelonephritis was only slightly higher than that of the general population. However, severe complications of pregnancy, such as preeclampsia, premature birth and acute renal failure, occurred more frequently in women with a history of renal scarring or hypertension (7 of 12) than in those with a history of recurrent infection alone (3 of 10). CONCLUSIONS: When renal scarring is present, reflux should be corrected before pregnancy to minimize maternal and fetal morbidity. When scarring is not present, the literature suggests that women with a history of reflux are at increased risk for pyelonephritis during pregnancy whether or not ureterocystostomy was performed. Pregnant women with a history of reflux may benefit from prophylactic antibiotics and women with reflux nephropathy should be followed throughout life.     

Effect of organisational downsizing on health of employees

BACKGROUND: Reduction of personnel by businesses and other organisations (organisational downsizing) is common in Europe, but little is known about its effects on the health of employees. METHODS: We used employers' records to investigate the relation between downsizing and subsequent absenteeism because of ill health in 981 local-government workers who remained in employment in Raisio, south-western Finland, during a period of economic decline (1991-95). Data were separated into three time periods: 1991, before downsizing; 1993, major downsizing in some workplaces and occupations; and 1993-95, after downsizing. We obtained data on sick leave from records kept by the occupational health-care unit in Raisio. We also investigated whether the effects of downsizing were dependent on ten other predictors of sick leave. FINDINGS: There was a significant association between downsizing and medically certified sick leave. The rate of absenteeism was 2.3 times greater (95% CI 2.0-2.7) after major downsizing, classified by occupation, than after minor downsizing. The corresponding rate ratios for musculoskeletal disorders and trauma were 5.7 (4.1-8.0) and 2.7 (1.7-4.2), respectively. The effects of downsizing by workplace depended on the age distribution of the staff. When the proportion of employees who were older than 50 years was high, downsizing increased the individual risk of absence because of ill health by 3.2-14.0 times, depending on diagnostic category. When the proportion of employees over 50 years was low, downsizing had only slight effects on health. Other risk factors that increased rates of sick leave after downsizing were age over 44 years, a large workplace, poor health before downsizing, and high income. INTERPRETATION: Downsizing is a risk to the health of employees. But this risk varies according to individual factors, such as age, socioeconomic status, and health, as well as factors related to place of work, for example, size and age structure of the staff.     

Social influences on drinking during pregnancy.

The influence of social networks on the drinking practices of pregnant women was examined. Pregnant women (n?=?153) were classified according lo whether they were heavy or light drinkers just before pregnancy and whether they reduced their alcohol risk status after pregnancy recognition. Failure to reduce alcohol risk status following pregnancy recognition among initially heavy drinkers was associated with reporting drinking as a social activity and difficulty in resisting social pressure to drink. There was also evidence that failure to reduce drinking was associated with greater approval for drinking during pregnancy and more frequent serving of alcohol among the social network. Findings suggest that interventions designed to reduce drinking among pregnant women help them to find alternative social activities and to develop strategies for resisting pressure to drink (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventive check-ups of pregnant women in Denmark. Common ailments in pregnancy

The study was conducted in order to describe the extent and content of advice on common ailments in pregnancy given by doctor or midwife during prenatal visits and to describe the frequency of ailments in the period before the visits. The design was a nationwide cross-sectional study based on questionnaires completed by pregnant women who had seen a general practitioner (GP), midwife or hospital doctor for prenatal care. Ailments and advice in connection with one specific visit were reported. The questionnaires were completed by 517 women after a prenatal visit to their GP (92% of eligible), by 514 women after a prenatal visit to the midwife (91% of eligible), and by 203 women after a prenatal visit to a doctor in the maternity department in pregnancy week 16-18 (84% of eligible). The results showed that nausea, pollakisuria, tiredness and heartburn had been present during the period before the visit in about half the women. Between a third and a fourth of the women had been discomforted by back pain, discharge or cramps. From 15 to 58 percent had been given advice, depending on the symptom. The advice was of many different kinds. To a large extent the women wanted to talk to the health professionals about the ailments, and most often they wanted to talk to a midwife about the ailments. We conclude that common ailments of pregnancy are frequent and they should be investigated more. Nearly all pregnant women want to talk about the subject during prenatal visits. The objectives of giving advice should be clearer, and clinical studies of the effectiveness of the advice are needed.