Pregnancy-related low back pain (LBP) and pelvic girdle pain (PGP) significantly affect the quality of life of pregnant women. Understanding their severity and risk factors may help prevent and alleviate such pain and their resulting dysfunction.
OBJECTIVE:
This study investigated the prevalence, severity, and biopsychosocial risk factors of pregnancy-related LBP and PGP in Zhengzhou, China.
METHODS:
The Numeric Pain Rating Scale (NPRS), Chinese version of the Roland-Morris Disability Questionnaire (RMDQ), and other questionnaires were self-administered by 1020 pregnant women undergoing treatment at a tertiary hospital between July and December 2019. Binary logistic regression was used to identify factors associated with pregnancy-related LBP and/or PGP.
RESULTS:
The prevalence of LBP and/or PGP during pregnancy was 63.0%, and most participants (80.4%) had both. The mean NPRS and RMDQ disability scores were 2.44 2.10 and 6.66 4.65, respectively. A higher gestational body mass index, LBP and/or PGP during menstruation, history of pregnancy-related LBP and/or PGP, and constant pressure were significantly associated with pregnancy-related LBP and/or PGP. Subjective support was a protective factor against LBP and/or PGP.
CONCLUSION:
The prevalence of LBP and/or PGP was high. The risk factors should be included in routine prenatal care to identify patients at risk of LBP and/or PGP.
BonnieLB. Maternal Adaptations to Pregnancy: Musculoskeletal Changes and Pain [EB/OL]. (2020-04-01) [2022-10-25]. http://https://www.uptodate.com/contents/zh-Hans/maternaladaptations-to-pregnancy-musculoskeletal-changes-and-pain?search=Musculoskeletal%20chest%20pain&source=searchresult&selectedTitle=726&usagetype=default&display.rank=7.
2.
FruscalzoACoccoPLonderoAPGantertM. Low back pain during pregnancy and delivery outcomes. Z Geburtshilfe Neonatol.2022; 226(2): 104-111.
3.
CeprnjaDChipchaseLFaheyPLiamputtongPGuptaA. Prevalence and factors associated with pelvic girdle pain during pregnancy in australian women: A cross-sectional study. Spine (Phila Pa 1976).2021; 46(14): 944-949.
4.
HameedFBartonTChiarelloC. Lumbopelvic Pain in Pregnancy in a Diverse Urban Patient Population: Prevalence and Risk Factors. J Womens Health (Larchmt). 2022; 30.Epub ahead of print.
5.
OnyemaechiNOChigbuCOUgwuEOOmokeNILasebikanOAOzumbaBC. Prevalence and risk factors associated with musculoskeletal disorders among pregnant women in Enugu Nigeria. Niger J Clin Pract.2021; 24(11): 1573-1581.
6.
MeucciRDPercevalAHLimaDRCousinEMarmittLPPizzatoPSilvaPADJesienSCesarJA. Occurrence of combined pain in the lumbar spine, pelvic girdle and pubic symphysis among pregnant women in the extreme south of Brazil. Rev Bras Epidemiol.2020; 23: e200037.
7.
OmokeNIAmaraegbulamPIUmeoraOUJOkaforLC. Prevalence and risk factors for low back pain during pregnancy among women in Abakaliki, Nigeria. Pan Afr Med J.2021; 39: 70.
8.
GoossensNGeraertsIVandenplasLVan VeldhovenZAsnongAJanssensL. Body perception disturbances in women with pregnancy-related lumbopelvic pain and their role in the persistence of pain postpartum. BMC Pregnancy Childbirth.2021; 21(1): 219.
9.
Oviedo-CaroMABueno-AntequeraJMunguía-IzquierdoD. The associations of pregnancy-related symptoms with health-related quality of life at midpregnancy: The PregnActive project. J Matern Fetal Neonatal Med.2021; 21: 1-9.
10.
MaiaLBAmaranteLGVitorinoDFMMascarenhasROLacerdaACRLourençoBMOliveiraVC. Effectiveness of conservative therapy on pain, disability and quality of life for low back pain in pregnancy: A systematic review of randomized controlled trials. Braz J Phys Ther.2021; 25(6): 676-687.
11.
WuytackFBegleyCDalyD. Risk factors for pregnancy-related pelvic girdle pain: A scoping review. BMC Pregnancy Childbirth.2020; 20(1): 739.
12.
BryndalAGlowinskiSMajchrzyckiM. Influence of pregnancy on the occurrence of lumbar spine pain in polish women: A retrospective study. J Pers Med.2022; 12(3): 357.
13.
SencanSOzcan-EksiEECuceIGuzelSErdemB. Pregnancy-related low back pain in women in Turkey: Prevalence and risk factors. Ann Phys Rehabil Med.2018; 61(1): 33-37.
14.
Starzec-ProserpioMWȩgrzynowskaMSysDKajdyARongiesWBaranowskaB. Prevalence and factors associated with postpartum pelvic girdle pain among women in Poland: A prospective, observational study. BMC Musculoskelet Disord.2022; 23(1): 928.
15.
BerberMASatılmışİG. Characteristics of low back pain in pregnancy, risk factors, and its effects on quality of life. Pain Manag Nurs.2020; 21(6): 579-586.
16.
NieminenLVuoriJKankaanpääM. An early biopsychosocial intervention design for the prevention of low back pain chronicity: A multidisciplinary empirical approach. J Rehabil Med.2022; 54: jrm00338.
17.
StugeBSorensenHAcharyaRSTveterAT. Prevalence of antenatal depressive symptoms and its associated factors among pregnant nepalese women with and without low back- and/or pelvic girdle pain. J Nepal Health Res Counc.2022; 19(4): 784-791.
18.
KielSSierocinskiERausCKnauthePChenotJF. Concordance of patient expectations regarding guideline recommendations for management of psychosocial factors in low back pain: A cross-sectional study. Pain Physician.2022; 25(4): E597-E607.
19.
O’SullivanKO’KeeffeMO’SullivanP. NICE low back pain guidelines: Opportunities and obstacles to change practice. Br J Sports Med.2017; 51: 1632-3.
20.
BahabadiFJEstebsariFRohaniCKandiZRKSefidkarRMostafaeiD. Predictors of health-promoting lifestyle in pregnant women based on pender’s health promotion model. Int J Womens Health.2020; 12: 71-7.
21.
AldabeDLawrensonPSullivanJHylandGBusseyMDHammerNBryantKWoodleySJ. Management of women with pregnancy-related pelvic girdle pain: An international Delphi study. Physiotherapy.2022; 115: 66-84.
22.
WuytackFDalyDCurtisEBegleyC. Prognostic factors for pregnancy-related pelvic girdle pain, a systematic review. Midwifery.2018; 66: 70-8.
23.
Fathnezhad-KazemiAAslaniAHajianS. Association between perceived social support and health-promoting lifestyle in pregnant women: A cross-sectional study. J Caring Sci.2021; 10(2): 96-102.
24.
Mahmoud AlilouMPakRMahmoud AlilouA. The Mediating Role of Coping Strategies and Emotion Regulation in the Relationship Between Pain Acceptance and Pain-Related Anxiety. J Clin Psychol Med Settings. 2022; 26.
25.
KuzuDKimSKratzAL. Active or passive pain coping: Which predicts daily physical and psychosocial functioning in people with chronic pain and spinal cord injury? Rehabil Psychol.2022; 67(3): 304-314.
26.
CarrollLMercadoACCassidyJDCôtéP. A population-based study of factors associated with combinations of active and passive coping with neck and low back pain. J Rehabil Med.2002; 34: 67-72.
27.
DownieWWLeathamPARhindVMWrightVBrancoJAAndersonJA. Studies with pain rating scales. Ann Rheum Dis.1978; 37: 378-81.
28.
BoltonJEHumphreysBKVan HedelHJA. Validity of weekly recall ratings of average pain intensity in neck pain patients. J Manipulative Physiol Ther.2010; 33: 612-7.
29.
RolandMO. The natural history of back pain. Practitioner.1983; 227: 1119-22.
30.
StugeBGarrattAKrogstad JenssenHGrotleM. The pelvic girdle questionnaire: A condition-specific instrument for assessing activity limitations and symptoms in people with pelvic girdle pain. Phys Ther.2011; 91: 1096-108.
31.
DuSHuYBaiYHuLDongJJinS, et al. Emotional distress correlates among patients with chronic nonspecific low back pain: A hierarchical linear regression analysis. Pain Pract.2019; 19: 510-21.
32.
ZhangYLiangDJiangRJiXWangYZhuJ, et al. Clinical, psychological features and quality of life of fibromyalgia patients: A cross-sectional study of Chinese sample. Clin Rheumatol.2018; 37: 527-37.
33.
XuJWeiY. Social support as a moderator of the relationship between anxiety and depression: An empirical study with adult survivors of wenchuan earthquake. PLoS One.2013; 8: 1-7.
34.
Zhangy. Influential Factor Analysis for Pregnancy – Related Low Back Pain Women Based on Structural Equation Modeling. 2017.
35.
SencanSOzcan-EksiEECuceIGuzelSErdemB. Pregnancy-related low back pain in women in Turkey: Prevalence and risk factors. Ann Phys Rehabil Med.2018; 61: 33-7.
36.
Shijagurumayum AcharyaRTveterATGrotleMEberhard-GranMStugeB. Prevalence and severity of low back- and pelvic girdle pain in pregnant Nepalese women. BMC Pregnancy Childbirth.2019; 19: 1-11.
37.
WangLY, LXXZhangH. Risk factos in late pregnancy related low back pain and pelvic pain. Lab Med Clin.2012; 9: 528-430.
38.
MogrenIM. BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy. Eur Spine J.2006; 15: 1093-102.
39.
WangSMDezinnoPMaranetsIBermanMRCaldwell-AndrewsAAKainZN. Low back pain during pregnancy: Prevalence, risk factors, and outcomes. Obstet Gynecol.2004; 104: 65-70.
40.
de AndradeCHSBitencourtRCLde FreitasRKGda CunhaLFMatosDCLiraPIC, et al. Factors associated with pain in the pelvic girdle in pregnant adolescents: A case-control study. Musculoskelet Sci Pract.2018; 38: 106-12.
41.
HuangHTChenSNWangY. Investigation on prevalence of low back pain and pelvic pain during pregnancy in Haikou city. Mod Prev Med.2014; 41: 3138-40.
42.
ZhangWGongHWangL-ZXi-zhengZ. Research progress ofbiomechanics for lumbar disc degeneration and injury. BME&Clin Med.2015; 18: 201-7.
43.
RobinsonHSVeierødMBMengshoelAMVøllestadNK. Pelvic girdle pain – Associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: A prospective cohort study. BMC Musculoskelet Disord. 2010; 11.
44.
VirgaraRMaherCVan KesselG. The comorbidity of low back pelvic pain and risk of depression and anxiety in pregnancy in primiparous women. BMC Pregnancy Childbirth.2018; 18: 1-7.
45.
BakkerECVan Nimwegen-MatzingerCWEkkel-Van Der VoordenWNijkampMDVöllinkT. Psychological determinants of pregnancy-related lumbopelvic pain: A prospective cohort study. Acta Obstet Gynecol Scand.2013; 92: 797-803.
46.
DemmelmaierIÅsenlöfPLindbergPDenisonE. Biopsychosocial predictors of pain, disability, health care consumption, and sick leave in first-episode and long-term back pain: A longitudinal study in the general population. Int J Behav Med.2010; 17: 79-89.
47.
DuSHuLBaiYDongJ, Jin Shengj i ZH. Influencing factors of self-efficacy level for patients with chronic low back pain in community. Nurs J Chin PLA.2016; 33: 1-7.
48.
YueQChenH, Ll Dong ZT. An overview about pain and socical support. Prog Mod Biomed.2012; 12: 2198-200.
49.
HoogendoornWEBongersPMDe VetHCWAriënsGAMVan MechelenWBouterLM. High physical work load and low job satisfaction increase the risk of sickness absence due to low back pain: Results of a prospective cohort study. Occup Environ Med.2002; 59: 323-8.
