Possible Predictive Factors for Low Back and Pelvic Pain at Three Months Postpartum Assessed in a Prospective Study from Early Pregnancy until the Postpartum Period

Many studies have shown that pregnancy-related low back and pelvic pain (LBPP) occurs from the second or third trimester to postpartum. LBPP is an important issue that affects pregnant women for a long period and continuation of LBPP has effects on infant rearing and return to work. Reduction of the severity of LBPP may improve the quality of daily life during pregnancy and postpartum.  

In this paper, the authors examined the intensity of LBPP, difficulty for daily life activity and mental health and their associations from early pregnancy until 3 months postpartum in a prospective study and also examined predictive factors for LBPP at 3 months postpartum. The study was conducted from March 2015 to August 2017 in a birth center in Kagawa Prefecture in Japan. The researchers recruited 55 pregnant women who responded to questionnaires in the first, second and third trimesters and at one week, one month and 3 months postpartum. They designed a self-administered questionnaire including a visual analog scale (VAS), pregnancy mobility index (PMI) of LBPP and Edinburgh postnatal depression scale (EPDS). 

The results revealed that there were significant differences in the proportions of women with LBPP in the first trimester (63.6%), second trimester (78.2%) and third trimester (83.6%) and at one week postpartum (80.0%), one month postpartum (69.1%) and 3 months postpartum (56.4%). VAS score at 3 months postpartum was significantly correlated with VAS scores at the first trimester (r = 0.410, p = 0.002), second trimester (r = 0.298, p = 0.027) and one month postpartum (r = 0.476, p < 0.001). VAS score at 3 months postpartum was significantly correlated with PMI scores at the first trimester and one month postpartum. The presence of LBPP at 3 months postpartum was significantly associated with the proportion of women with LBPP at the first trimester. In multiparous women, predictive factor of LBPP at 3 months postpartum was a past history of LBPP in the previous pregnancy.

In conclusion, the proportion of women with LBPP and the intensity of LBPP were increased at late pregnancy and gradually decreased until 3 months postpartum. LBPP at 3 months postpartum was associated with LBPP at the first trimester and a past history of LBPP in a previous pregnancy was an important factor for prediction of LBPP at 3 months postpartum. Provision of information regarding LBPP and confirmation of LBPP before pregnancy in addition to assessment of LBPP at early pregnancy are necessary for reduction of LBPP at 3 months postpartum.

Article by Yuko Uemura, et al, from Japan.

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