Pelvic girdle pain - associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study

Abstract

BackgroundRecent studies have shown high prevalence rates for pelvic girdle pain (PGP) in pregnancy. Some risk factors for developing PGP have been suggested, but the evidence is weak. Furthermore there is almost no data on how findings from clinical examinations are related to subsequent PGP. The main purpose for this study was to study the associations between socio-demographical, psychological and clinical factors measured at inclusion in early pregnancy and disability or pain intensity in gestation week 30.MethodsThis is a prospective cohort study following women from early to late pregnancy. Eligible women were recruited at their first attendance at the maternity care unit. 268 pregnant women answered questionnaires and underwent clinical examinations in early pregnancy and in gestation week 30. We used scores on disability and pain intensity in gestation week 30 as outcome measures to capture the affliction level of PGP. Multiple linear regression analysis was used to study the associations between potential risk factors measured in early pregnancy and disability or pain intensity in gestation week 30.ResultsSelf-reported pain locations in the pelvis, positive posterior pelvic pain provocation (P4) test and a sum of pain provocation tests in early pregnancy were significantly associated with disability and pain intensity in gestation week 30 in a multivariable statistic model. In addition, distress was significantly associated with disability. The functional active straight leg raise (ASLR) test, fear avoidance beliefs and the number of pain sites were not significantly associated with either disability or pain intensity.ConclusionsThe results suggest that a clinical examination, including a few tests, performed in early pregnancy may identify women at risk of a more severe PGP late in pregnancy. The identification of clinical risk factors may provide a foundation for development of targeted prevention strategies.

Predictors for long-term disability in women with persistent postpartum pelvic girdle pain

“…The ASLR test performed postpartum has also been found to be predictive of disability and evening pain in women with persistent PGP 12 months postpartum [10]. However, when the test was performed during pregnancy, it could not predict disability or pain 3 months postpartum [8] or late in pregnancy [9] in women with PGP. One can speculate that long-term disability in women with postpartum PGP arises from mechanisms different from those involved in short-term outcomes.…”

“…In addition to elapsed time from pregnancy, it may be important to take interaction effects into account when looking for predictors of long-term disability in women with persistent postpartum PGP. Significant interaction effects have not been identified from measurements collected during pregnancy [8,9].…”

“…Recent studies of predictors have defined subgroups of patients with pregnancy-related lumbopelvic pain and have focused on PGP [2,[8][9][10]. Factors such as older age, work dissatisfaction, and pain location have been proposed as important predictors for postpartum PGP [2].…”

Is pregnancy related pelvic girdle pain associated with altered kinematic, kinetic and motor control of the pelvis? A systematic review

“…These factors have been presented as strong risk factors for developing PPGP [2,[33][34][35][36]. Studies controlling for one or more than one of the above listed factors were awarded with one or two points, respectively.…”

Svangerskapsrelaterte bekkenplager

“…Sterke smerter, økt psykisk stress og positiv P4-test (posterior pelvic pain provocation test, smerteprovokasjon av bakre bekken) tidlig i svangerskapet predikerer mer smerte og dårligere funksjon i 30. uke (3). Sterke smerter i svangerskapet gir mer plager og funksjonssvikt etter fødselen (4).…”