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S. Morino1, T. Aoyama2
1Osaka Prefecture University, Department of Physical Therapy, Faculty of Comprehensive Rehabilitation, Habikino, Japan, 2Kyoto University, Department of Physical Therapy, Human Health Sciences, Kyoto, Japan
Background: During pregnancy and after childbirth, various changes occur to a woman’s body such as the body weight gain, swelling of the abdomen with the fetus growth, and the changes of bone alignment especially around the pelvis, which are closely related to pregnancy-related symptoms such as pain around the lumbar section and pelvis. Approximately 45% of pregnant women and 25% of postpartum women experience low back pain and pain around the pelvis. These types of pain lower the quality of life for many women. The epidemiology and etiology of such pain have been investigated, but few have reported on the change of the pains longitudinally. Information about history of these changes in the woman’s body during the perinatal period could become an index for medical advice for women. However, it is not clear when and how some of these pains occur.
Purpose: The present longitudinal study aimed to investigate the history of pain around the lumbopelvic region during perinatal period of Japanese women.
Methods: A total of 170 pregnant women were evaluated at 12, 24, 30, and 36 weeks of pregnancy, early days after childbirth, and 1 month after childbirth. Using the Numerical Rating Scale, the presence and extent of pain in the following areas was assessed: sacroiliac joint, pubic region, groin region, and lower back. To determine the change of prevalence of pain, he descriptive statistics were conducted using the answer whether they felt pain or not. Additionally, the change in the intensity of pain was analyzed using the descriptive statistics of the participants who felt pain.
Results: Low back pain had the highest occurrence among the four regions. Pain in the sacroiliac joint showed a twofold increase from 12 to 24 weeks, and that in the pubic region, with the lowest prevalence at 12 weeks, suddenly increased after 24 weeks of pregnancy and reached over 50% at 36 weeks of pregnancy. The incidence of all four pains reduced after childbirth. With regard to the pain intensity, pain in the pubic and groin areas increased sharply during pregnancy toward and into the early days after childbirth. Meanwhile, the change in intensity of low back pain was lower than that in other regions. Sacroiliac joint pain showed the most characteristic change as it was in the highest level among the four pains during pregnancy. Moreover, we observed that the severity was the highest at 30 weeks of pregnancy and decreased after this point, although for the other three pain regions, the severity was at the highest level during the early days after childbirth.
Conclusion(s): The history of pains around the lumbopelvic region during the perinatal period was investigated and various changes in the nature of these pains were revealed in this study. Our results could be an index of harmful symptoms that many women experience during pregnancy.
Implications: Careful pain management appropriate to the timing of the pregnancy period based on our findings could be performed, and the nature and intensity of pain during perinatal period could be predicted.
Funding, acknowledgements: This study was supported by JKA promotion funds from Auto Race (2019M-186)
Keywords: pregnancy, low back pain, pelvic girdle pain
Topic: Pelvic, sexual and reproductive health
Did this work require ethics approval? Yes
Institution: Kyoto University
Committee: Ethics Committee of the Kyoto University Graduate School of Medicine
Ethics number: E2076
All authors, affiliations and abstracts have been published as submitted.
