Risk factors for pelvic girdle pain postpartum and pregnancy related low back pain postpartum; a systematic review and meta-analysis. (August 2020)

• Record Type: Journal Article
• Authors: Wiezer, M.; Hage-Fransen, M.A.H.; Otto, A.; Wieffer-Platvoet, M.S.; Slotman, M.H.; Nijhuis-van der Sanden, M.W.G.; Pool-Goudzwaard, A.L.
• Is Part Of: Musculoskeletal science and practice. Volume 48(2020)
• Publication Date: 2020-08
• Subjects: Pelvic girdle pain -- Postpartum period -- Pregnancy -- Low back pain -- Risk factors; Manipulation (Therapeutics) -- Periodicals; Physical therapy -- Periodicals; Neuromuscular diseases -- Treatment -- Periodicals; Musculoskeletal system -- Diseases -- Periodicals; Manipulation (Therapeutics); Neuromuscular diseases -- Treatment; Physical therapy; Manipulation, Orthopedic; Musculoskeletal Diseases -- therapy; Neuromuscular Diseases -- therapy; Physical Therapy Modalities; Electronic journals; Periodicals; 615.82
• DOI: 10.1016/j.msksp.2020.102154
• Languages: English
• ISSNs: 2468-8630

Abstract

Abstract: Background: Although pelvic girdle pain postpartum and pregnancy related low back pain postpartum (combined and named PGPP in this study) have a natural favourable course, there is a subgroup of women who have persistent complaints. The objective of this study was to identify personal-, (pre)pregnancy-, obstetric-, and child related risk factors on PGPP by means of a systematic literature review and meta-analysis. Methods: Literature searches of PubMed, EMBASE, CINAHL and Cochrane up to October 2018 were conducted. Prospective cohort studies in English or Dutch describing three or more risk factors for PGPP were included. We assessed articles for inclusion and risk of bias. Studies with high risk of bias were excluded from data extraction. Data was extracted and checked for accuracy confirming to the CHARMS-checklist. Homogeneous variables were pooled. Results: Twelve full text studies were assessed. Seven studies were excluded due to high risk of bias. Data was extracted from five studies. Multivariate analysis was not possible due to heterogeneity in included risk factors as well as outcome measures on risk factor per study. Pooled univariate significant risk factors on PGPP were: a history of low back pain, pre-pregnancy body mass index >25, pelvic girdle pain in pregnancy, depression in pregnancy, and a heavy workload in pregnancy. No significant obstetric and child related risk factors were reported. Conclusions: Risk factors on PGPP have been identified. Since multivariate analysis was not possible the outcome should be treated with care, because interaction between risk factors could not be analysed. Highlights: Several risk factors on persistent pelvic girdle pain after delivery are detected. A Body Mass Index over 25 before getting pregnant increases the risk. Low back pain before, and pelvic girdle pain in pregnancy increase the risk. Women who are depressed in pregnancy are at greater risk. A heavy workload in pregnancy is a risk factor on pelvic girdle pain after delivery.