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BMI, pain and hyper-mobility are determinants of long-term outcome for women with low back pain and pelvic pain during pregnancy

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Abstract

Low back pain and pelvic pain (LBPP) is common during pregnancy and up to 40% of women still have symptoms half a year after delivery. The aim of the study was to investigate determinants and the prevalence of persistent LBPP after pregnancy in a Swedish cohort. In a previous study 891 women had responded to a questionnaire on risk factors and prevalence of LBPP during pregnancy. Altogether 72% (n=639) of the women had reported LBPP during pregnancy. These respondents were sent a second questionnaire at approximately 6 months after delivery. The response rate was 72.6% (n=464). Independent t-test and Pearson’s chi-squared test were used to test the difference between the two groups. In response to the questionnaire, 43.1% of the women reported persistent LBPP 6 months after delivery. Women with persistent LBPP after pregnancy had had significantly earlier onset of pain during pregnancy, higher maternal age, higher body mass index (BMI), and assessed a higher level of pain due to LBPP during pregnancy and after pregnancy, and included a higher proportion of women with joint hyper-mobility. In summary, recurrent or continuous LBPP is prevalent after pregnancy. BMI as well as hyper-mobility are prominent determinants of persistent LBPP after pregnancy. Level and onset of pain during pregnancy were strong predictors of persistent LBPP.

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Abbreviations

Q1:

The first questionnaire after delivery

Q2:

The second questionnaire at approximately 6 months after delivery

SD:

Standard deviation

VAS:

Visual analogue scale

References

  1. Albert H, Godskesen M, Westergaard J (2001) Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand 80:505–510

    Article  PubMed  CAS  Google Scholar 

  2. Berg G, Hammar M, Moller-Nielsen J, Linden U, Thorblad J (1988) Low back pain during pregnancy. Obstet Gynecol 71:71–75

    PubMed  CAS  Google Scholar 

  3. Biering-Sorensen F (1982) Low back trouble in a general population of 30-, 40-, 50-, and 60-year-old men and women. Study design, representativeness and basic results. Dan Med Bull 29:289–299

    PubMed  CAS  Google Scholar 

  4. Biering-Sorensen F (1983) A prospective study of low back pain in a general population. I. Occurrence, recurrence and aetiology. Scand J Rehabil Med 15:71–79

    PubMed  CAS  Google Scholar 

  5. Bjorklund K, Naessen T, Nordstrom ML, Bergstrom S (1999) Pregnancy-related back and pelvic pain and changes in bone density. Acta Obstet Gynecol Scand 78:681–685

    Article  PubMed  CAS  Google Scholar 

  6. Breen TW, Ransil BJ, Groves PA, Oriol NE (1994) Factors associated with back pain after childbirth. Anesthesiology 81:29–34

    Article  PubMed  CAS  Google Scholar 

  7. Fast A, Shapiro D, Ducommun EJ, Friedmann LW, Bouklas T, Floman Y (1987) Low-back pain in pregnancy. Spine 12:368–371

    Article  PubMed  CAS  Google Scholar 

  8. Hansen A, Jensen DV, Wormslev M, Minck H, Johansen S, Larsen EC, Wilken-Jensen C, Davidsen M, Hansen TM (2000) [Pregnancy associated pelvic pain. II: Symptoms and clinical findings]. Ugeskr Laeger 162:4813–4817

    PubMed  CAS  Google Scholar 

  9. Kristiansson P, Svardsudd K, von Schoultz B (1996) Back pain during pregnancy: a prospective study. Spine 21:702–709

    Article  PubMed  CAS  Google Scholar 

  10. Larsen EC, Wilken-Jensen C, Hansen A, Jensen DV, Johansen S, Minck H, Wormslev M, Davidsen M, Hansen TM (1999) Symptom-giving pelvic girdle relaxation in pregnancy. I: Prevalence and risk factors. Acta Obstet Gynecol Scand 78:105–110

    Article  PubMed  CAS  Google Scholar 

  11. Mens JM, Vleeming A, Stoeckart R, Stam HJ, Snijders CJ (1996) Understanding peripartum pelvic pain. Implications of a patient survey (discussion 1369–1370). Spine 21:1363–1369

    Article  PubMed  CAS  Google Scholar 

  12. Mogren I (2006) Perceived health, sick leave, psychosocial situation, and sexual life in women with low back pain and pelvic pain during pregnancy. Acta Obstet Gynecol Scand (in press)

  13. Mogren I (2005) Previous physical activity decreases the risk of low back pain and pelvic pain during pregnancy. Scand J Public Health 33:300–306

    PubMed  Google Scholar 

  14. Mogren IM, Pohjanen AI (2005) Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine 30:983–991

    Article  PubMed  Google Scholar 

  15. Nilsson-Wikmar L, Harms-Ringdahl K, Pilo C, Pahlback M (1999) Back pain in women post-partum is not a unitary concept. Physiother Res Int 4:201–213

    Article  PubMed  CAS  Google Scholar 

  16. Nilsson-Wikmar L, Pilo C, Pahlback M, Harms-Ringdahl K (2003) Perceived pain and self-estimated activity limitations in women with back pain post-partum. Physiother Res Int 8:23–35

    Article  PubMed  Google Scholar 

  17. Noren L, Ostgaard S, Johansson G, Ostgaard HC (2002) Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J 11:267–271

    Article  PubMed  Google Scholar 

  18. Ostgaard HC, Andersson GB (1992) Postpartum low-back pain. Spine 17:53–55

    Article  PubMed  CAS  Google Scholar 

  19. Ostgaard HC, Andersson GB, Karlsson K (1991) Prevalence of back pain in pregnancy. Spine 16:549–552

    Article  PubMed  CAS  Google Scholar 

  20. Ostgaard HC, Roos-Hansson E, Zetherstrom G (1996) Regression of back and posterior pelvic pain after pregnancy. Spine 21:2777–2780

    Article  PubMed  CAS  Google Scholar 

  21. Ostgaard HC, Zetherstrom G, Roos-Hansson E (1997) Back pain in relation to pregnancy: a 6-year follow-up. Spine 22:2945–2950

    Article  PubMed  CAS  Google Scholar 

  22. Russell R, Dundas R, Reynolds F (1996) Long term backache after childbirth: prospective search for causative factors. BMJ 312:1384–1388

    PubMed  CAS  Google Scholar 

  23. Saugstad LF (1991) Is persistent pelvic pain and pelvic joint instability associated with early menarche and with oral contraceptives? Eur J Obstet Gynecol Reprod Biol 41:203–206

    Article  PubMed  CAS  Google Scholar 

  24. Svensson HO, Andersson GB, Hagstad A, Jansson PO (1990) The relationship of low-back pain to pregnancy and gynecologic factors. Spine 15:371–375

    Article  PubMed  CAS  Google Scholar 

  25. To WW, Wong MW (2003) Factors associated with back pain symptoms in pregnancy and the persistence of pain 2 years after pregnancy. Acta Obstet Gynecol Scand 82:1086–1091

    Article  PubMed  CAS  Google Scholar 

  26. Turgut F, Turgut M, Cetinsahin M (1998) A prospective study of persistent back pain after pregnancy. Eur J Obstet Gynecol Reprod Biol 80:45–48

    Article  PubMed  CAS  Google Scholar 

  27. Wu WH, Meijer OG, Uegaki K, Mens JM, Van Dieen JH, Wuisman PI, Ostgaard HC (2004) Pregnancy-related pelvic girdle pain (PPP). I: Terminology, clinical presentation, and prevalence. Eur Spine J 575–589

    Article  Google Scholar 

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Acknowledgments

The author is grateful to Anna Pohjanen, gynecologist at the Department of Obstetrics and Gynecology, Sunderby Hospital for good collaboration on data collection; and the project assistant, Anita Nilsson, for the excellent assistance. The author would like to thank all women participants for sharing their obstetric history and experiences during pregnancy and after delivery. This study was supported by grants from the County Council of Västerbotten, the Joint Committee of the Northern Sweden Health Care Region, and the Medical Faculty of Umeå University.

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Correspondence to Ingrid M. Mogren.

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Mogren, I.M. 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 15, 1093–1102 (2006). https://doi.org/10.1007/s00586-005-0004-9

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  • DOI: https://doi.org/10.1007/s00586-005-0004-9

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