Pelvic girdle pain in pregnancy: The impact on function

Robinson, Hilde Stendal; Eskild, Anne; Heiberg, Eli; Eberhard‐Gran, Malin

doi:10.1080/00016340500410024

Cited by 86 publications

(99 citation statements)

References 18 publications

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“…This subgroup has been associated with greater functional disability, more frequent sick leave, and significantly worse prognosis than pain in one or two pelvic locations. 2,3,28 Furthermore, it has previously been shown that the number of pain sites has a strong predictor utility. 9 This strengthens our classification of severity level during pregnancy, which was based on pain intensity, pain location, and the number of pain sites.…”

Section: Discussionmentioning

confidence: 99%

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The effect of emotional distress on persistent pelvic girdle pain after delivery: a longitudinal population study

Bjelland

Stuge

Engdahl

et al. 2012

BJOG

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Objective To study the prognosis for pelvic girdle pain, and to explore the association between presence of emotional distress during pregnancy and pelvic girdle syndrome 6 months after delivery.Design Longitudinal population study. Main outcome measure Pelvic girdle syndrome 6 months after delivery, defined as pain in the anterior pelvis and on both sides in the posterior pelvis.Results Six months after delivery, 78.0% of the women had recovered, 18.5% reported persistent pain in one or two pelvic locations, 3.0% reported pelvic girdle syndrome and 0.5% reported severe pelvic girdle syndrome. The recovery rates decreased with increasing levels of pain severity in pregnancy. Being emotionally distressed at two time points during pregnancy was associated with the presence of pelvic girdle syndrome (adjusted OR 1.5, 95% CI 1.2-1.9) and severe pelvic girdle syndrome (adjusted OR 1.9, 95% CI 1.1-3.1), after adjustment for pain severity in pregnancy, other medical conditions, body mass index, age at menarche, previous low back pain, and smoking during pregnancy.Conclusions In this follow-up of women with pelvic girdle pain in pregnancy, the recovery rates after delivery were high. Our findings suggest that the presence of emotional distress during pregnancy is independently associated with the persistence of pelvic girdle pain after delivery.Keywords Emotional distress, pelvic girdle pain, pregnancy, prognostic factors, prospective cohort, the Norwegian Mother and Child Cohort Study.Please cite this paper as: Bjelland E, Stuge B, Engdahl B, Eberhard-Gran M. The effect of emotional distress on persistent pelvic girdle pain after delivery: a longitudinal population study . BJOG 2013;120:32-40.

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Section: Discussionmentioning

confidence: 99%

“…1,2 Hence, it should be regarded as a major women's health issue. The reported recovery rates after delivery are high.…”

Section: Introductionmentioning

confidence: 99%

The effect of emotional distress on persistent pelvic girdle pain after delivery: a longitudinal population study

Bjelland

Stuge

Engdahl

et al. 2012

BJOG

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“…Both low back pain (LBP) and pelvic girdle pain (PGP) develop in many women during pregnancy [3,22,25]. In a smaller fraction, the pain persists for years after childbirth [14,23].…”

Section: Introductionmentioning

confidence: 99%

“…Two studies concluded that level and onset of pain during pregnancy were strong predictors for persistent lumbopelvic pain [20,29]. Prepregnancy back pain and severity of complaints were also found to play a prognostic role in the study of Röst and co-workers [26], whereas a retrospective study found no association between previous back pain and PGP [25]. One study indicates that pain location might be important [1].…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors for recovery from postpartum pelvic girdle pain

Vøllestad

Stuge

2009

Eur Spine J

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Pelvic girdle pain (PGP) has a high incidence during pregnancy and in some women pain will persist for years. Most studies have used pain as the outcome measure, and little attention is given to functioning or disability. A better understanding of prognostic factors for recovery seems important for clinical care and treatment. The aim of the present paper was to identify prognostic factors for recovery from postpartum PGP and disability, and to determine the impacts of prognostic factors when pain intensity and disability are used as outcome measures. Seventy-eight women with diagnosed PGP were included 6-16 weeks postpartum. Possible prognostic factors were obtained through clinical tests and questionnaires at baseline. The clinical tests were posterior pelvic pain provocation (P4) test, active straight leg raise (ASLR) test and pain provocation of long dorsal sacroiliac ligament (LDL). One year postpartum outcome measures were obtained by Oswestry disability index (ODI ver 2.0) and worst evening pain (VAS 0-100). Multiple linear regression and logistic regression analyses were used to identify significant prognostic factors. At baseline 60% believed they would recover and 40% were uncertain or believed they would not recover. Fifty per cent had a history of low back pain (LBP), and 20% had high emotional distress (HSCL25-item C1.75). About 75% had positive LDL and P4 at both sides and 24% had pain located to all three pelvic joints. Forty per cent had ASLR scores of at least 4 (sum score range 0-10). Multivariate analyses showed consistently that ASLR and belief in improvement were statistical significant predictors for both disability and pain as outcome measures. ASLR score \4 predicted 10 points lower ODI and 19 points lower evening pain compared with having ASLR score of at least 4. Pain location was a statistical significant predictor in only one analysis. History of LBP or high psychological distress was not prognostic for recovery. ASLR test and belief in improvement are predictors of clinical significance in women having PGP postpartum.

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“…Consequently, this musculoskeletal disorder is responsible for high levels of sick leave and financial cost [2]. Studies report PPGP and low back pain account for one-third of sick leave in the Scandinavian countries [3][4][5]. Interestingly, PPGP is not influenced by economic or cultural differences when comparing different countries [6].…”

Section: Introductionmentioning

confidence: 99%

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

2012

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Purpose To determine the level of evidence for altered mechanical and motor control of the pelvis being associated with pregnancy-related pelvic girdle pain (PPGP). Methods This systematic review was undertaken by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six different databases were used for the electronic search. Observational cohorts, cross sectional or case-control studies focused on the association between altered kinematic/kinetic and motor control of the pelvis and PPGP during pregnancy were included. Study selection was conducted by two reviewers who firstly screened for titles, then for abstracts and finally for full articles. The Newcastle-Ottawa scale and the guidelines proposed by the Cochrane back review group were used to assess risk of bias and quality of evidence, respectively. Results 354 references were identified, and after excluding unwanted articles, 10 studies met the final inclusion criteria. Studies not related to motor control or pelvic mobility were the main reason for exclusion. Seven studies were case-control and three were prospective cohort studies. Seven studies were ranked as high while three were ranked as low quality. Among the high quality studies, six found association between PPGP and altered motor control and mobility of the pelvis.Conclusions The level of evidence for an association between PPGP and altered motor control and kinematic or kinetic parameters of the pelvis was found to be moderate.

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Pelvic girdle pain in pregnancy: The impact on function

Abstract: Pain related to the pelvic joints is common among pregnant women in Norway and may cause serious functional problems.

Cited by 86 publications

References 18 publications

The effect of emotional distress on persistent pelvic girdle pain after delivery: a longitudinal population study

The effect of emotional distress on persistent pelvic girdle pain after delivery: a longitudinal population study

Prognostic factors for recovery from postpartum pelvic girdle pain

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

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