Risk factors for persistent pelvic girdle pain pregnancy-related (PPGP): a Systematic Review and meta-analysis approach

Abstract

Our review want to identify most incident risk factors that determine the persistence of PGP at 3-6 months after childbirth in women with PPGP or PPGP and PLBP, because of about 1/3 does not recover after childbirth and continues to experience symptoms after three months and in some cases up to two years. The research was performed on the databases ofMedline, Cochrane, Pedro, Scopus, Web of Science and Chinal from December 2018 to January 2022 following the indications of the PRISMA statement 2009 - and updated according to the PRISMA 2020- including observational cohort studies and prospective questionnaires in English. Two authors independently selected studies excluding specific, traumatic, gynecological / urological cause PGP or isolated PLBP and studies that did not include the primary outcome (presence / absence of PGP); studies with an initial assessment in pregnancy / within one month of delivery and with at least a follow-up at least 3 months after delivery were included. Two independent authors then performed an evaluation of the ROB using the QUIPS tool. Finally, in-depth qualitative analysis was conducted, since due to high degree of heterogeneity in the data collection of the included studies and lack of raw data suitable for quantitative analysis, it was not possible to carry out the originally assumed meta-analyzes for subgroups. High levels of pain in pregnancy, high number of positive provocative tests, history of LBP / LPP, high levels of disability in pregnancy, neurosis and high levels of Fear Avoidance Belief are main predictors of PPGP.