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E. Aota1, K. Kitagaki2, K. Tanaka3, K. Horibe1, R. Ono1
1Kobe University Graduate School of Health Sciences, Department of Community Health Sciences, Kobe, Hyogo, Japan, 2National Cerebral and Cardiovascular Center, Department of Cardiovascular Rehabilitation, Suita, Japan, 3Tanabe Orthopedics, Department of Rehabilitation, Osaka, Japan
Background: Postpartum lumbopelvic pain (LBPP) is the most frequent symptom during pregnancy and half of them remain persistent after delivery. Pregnancy-related LBPP is largely due to the physical and morphological changes that occur during pregnancy, which continue until approximately 4-6 weeks after delivery, but then resolve. So, new additional factors might contribute to postpartum LBPP prolongation. In spite of international guidelines recommend physical activity (PA), many postpartum women spend inactivity for long time. Furthermore, the content of PA accompanying childcare is likely to differ between primiparous and multiparous women.
Purpose: Hence, the primary aim of this case control study was to examine the impact of sedentary behavior after childbirth on postpartum LBPP prolongation. The secondary aim of this study was to investigate the difference in the impact of sedentary behavior between primiparous and multiparous women.
Methods: This case control study followed up women who had reported LBPP at 4-month postpartum and divided them into the presence or absence of LBPP at 10-month postpartum. Sedentary time and physical activity were assessed at 4-month postpartum using the International Physical Activity Questionnaire short form. Univariate and multivariate logistic regression analysis was used to calculate persistent LBPP odds ratios (ORs) according to sedentary times, followed stratification analysis by parity.
Results: A total of 182 women (32.1±5.1 years old) were included for analysis and 112 (61.5%) participants had persistent LBPP at 10-month postpartum. Those with persistent LBPP at 10-month after delivery had increased sedentary time [5.0 (3.0-7.0) hours vs. 3.5 (2.0-6.0) hours, p = 0.05] at 4-month compared to those without LBPP. Even after adjusting for confounding factors, longer sedentary time at 4-month postpartum affected persistent LBPP at 10-month postpartum in primiparas [adjusted OR (95% confidence interval (CI)) = 1.28 (1.05-1.55)]. In contrast, in multiparous women, sedentary behavior at 4-month postpartum did not have a significant impact on persistent postpartum LBPP [adjusted OR (95% CI) = 0.96 (0.86-1.07)]. Factors affecting postpartum LBPP prolongation in multiparas was only the intensity of LBPP at 4-month postpartum.
Conclusion(s): The present study found that sedentary behavior during the postpartum period was associated with persistent postpartum LBPP only in primiparas.
Implications: The finding suggests that reducing sedentary time after delivery might be beneficial in preventing postpartum LBPP prolongation in primiparas who cannot secure sufficient leisure-time physical activity. On the other hand, it is desirable for all and multiparous women to pay attention to psychosocial approaches to pain intensity and depressive symptoms instead of sedentary behavior.
Funding, acknowledgements: この作業を支援するための資金は受け取っていません。
Keywords: physical activity, postpartum, low back pain
Topic: Pelvic, sexual and reproductive health
Did this work require ethics approval? Yes
Institution: Kobe University Graduate School of Health Sciences
Committee: Research Ethics Committee of Kobe University Graduate School
Ethics number: 449-1
All authors, affiliations and abstracts have been published as submitted.
