REVAL Rehabilitation Research Center, UHasselt - Hasselt University, Agoralaan A, 3590, Diepenbeek, Belgium.
Department of Rehabilitation Sciences, KU Leuven, ON IV Herestraat 49 - box 1510, 3000, Leuven, Belgium.
BMC Pregnancy Childbirth. 2021 Mar 18;21(1):219. doi: 10.1186/s12884-021-03704-w.
Lumbopelvic pain (LPP) is common during pregnancy and can have long-lasting negative consequences in terms of disability and reduced quality of life. Therefore, it is crucial to identify women at risk of having pregnancy-related LPP after childbirth. This study aimed to investigate the association between body perception, pain intensity, and disability in women with pregnancy-related LPP during late pregnancy and postpartum, and to study whether a disturbed body perception during late pregnancy predicted having postpartum LPP.
A prospective cohort study in 130 primiparous women (median age = 30 years) was performed. Pain intensity, disability, and lumbopelvic body perception during the last month of pregnancy and 6 weeks postpartum were assessed with the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index, and Fremantle Back Awareness Questionnaire, respectively. Having pregnancy-related LPP was defined as an NPRS score ≥ 1/10. At both timepoints, women were categorized into three groups; pain-free, LPP with low disability, and LPP with high disability (based on Oswestry Disability Index scores). At each timepoint, body perception was compared between groups, and correlations between body perception, pain intensity, and disability were evaluated in women with LPP by using non-parametric tests. Logistic regression analysis was used to determine whether body perception during the last month of pregnancy predicted the presence of LPP 6 weeks postpartum.
Women with LPP at the end of pregnancy, and 6 weeks postpartum reported a more disturbed body perception compared to pain-free women (p ≤ 0.005). Greater body perception disturbance correlated with higher pain intensity (σ = 0.266, p = 0.008) and disability (σ = 0.472, p < 0.001) during late pregnancy, and with pain intensity 6 weeks postpartum (σ = 0.403, p = 0.015). A disturbed body perception during late pregnancy nearly significantly predicted having postpartum LPP (Odds Ratio = 1.231, p = 0.052).
Body perception disturbance was greater in women experiencing LPP during late pregnancy and postpartum compared to pain-free women, and correlated with pain intensity and disability. Though non-significant (p = 0.052), the results of the regression analysis suggest that greater body perception disturbance during late pregnancy might predict having LPP postpartum. However, future studies should follow up on this.
腰骨盆疼痛（LPP）在妊娠期间很常见，会对残疾和生活质量产生长期的负面影响。因此，识别分娩后与妊娠相关的 LPP 风险妇女至关重要。本研究旨在探讨妊娠晚期和产后与妊娠相关的 LPP 妇女的身体感知、疼痛强度和残疾之间的关系，并研究妊娠晚期身体感知障碍是否预测产后 LPP。
对 130 名初产妇（中位年龄 30 岁）进行前瞻性队列研究。使用数字疼痛评分量表（NPRS）、Oswestry 残疾指数和 Fremantle 背部感知问卷分别评估妊娠最后一个月和产后 6 周时的疼痛强度、残疾和腰骨盆身体感知。将与妊娠相关的 LPP 定义为 NPRS 评分≥1/10。在这两个时间点，根据 Oswestry 残疾指数评分，将女性分为三组；无痛、低残疾的 LPP 和高残疾的 LPP。在每个时间点，比较各组之间的身体感知，并使用非参数检验评估 LPP 女性的身体感知与疼痛强度和残疾之间的相关性。使用逻辑回归分析确定妊娠最后一个月的身体感知是否预测产后 6 周时的 LPP 存在。
妊娠末期和产后 6 周时患有 LPP 的女性报告的身体感知障碍较无痛女性更为严重（p≤0.005）。较大的身体感知障碍与妊娠晚期的疼痛强度（σ=0.266，p=0.008）和残疾（σ=0.472，p<0.001）以及产后 6 周的疼痛强度（σ=0.403，p=0.015）相关。妊娠晚期的身体感知障碍几乎显著预测产后 LPP（优势比=1.231，p=0.052）。
与无痛女性相比，妊娠晚期和产后经历 LPP 的女性的身体感知障碍更大，并且与疼痛强度和残疾相关。尽管回归分析的结果没有达到显著水平（p=0.052），但结果表明，妊娠晚期的身体感知障碍可能预测产后 LPP。然而，未来的研究应该对此进行跟进。
