Pelvic girdle pain and disability during and after pregnancy : a cohort study

Abstract

Pelvic girdle pain (PGP) is frequently reported in pregnancy and impacts the women’s activity level. Both prevalence and severity of PGP is uncertain. Most women recover after delivery, but a considerable number develop chronic pain and functional problems. It is important to identify clinical risk factors for PGP that could be targeted by treatment strategies. Main objectives: estimate the prevalence of PGP at different times; examine the associations between responses to clinical tests and disability; identify risk factors for development of PGP and disability during and after pregnancy 326 pregnant women were studied and followed through pregnancy. Data were collected by questionnaires and clinical examinations in early pregnancy, gestation week 30, and 12 weeks postpartum. Socio-demographical and psychological factors as well as pain locations and responses to clinical tests were used as explanatory variables. Disability and pain intensity were used as response variables. PGP was reported by 35%, 62% and 31% of the women in early pregnancy, gestation week 30, and 12 weeks postpartum respectively. Disability varied at all times independent of the presence or absence of PGP. Pain locations in the pelvic area, responses to clinical tests and disability were strongly associated in gestation week 30. Pain locations in the pelvic area and positive pain provocation tests, assessed in early pregnancy, were risk factors for disability and pain intensity in late pregnancy. Distress was also associated with disability. Sum of positive pain provocation tests in late pregnancy was risk factor for both disability and pain intensity 12 weeks postpartum. Number of pain sites in other bodily areas and pre-pregnancy low back pain was risk factor for pain intensity and disability respectively. The large variation in disability at all times, independent of PGP, shows that pregnancy itself impacts function. The high prevalence of PGP is probably an overestimation of affliction and stresses the importance of functional assessment.