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Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem

Yıl 2023, Cilt: 26 Sayı: 2, 99 - 106, 23.06.2023

Hacer Erten Mahmure Aygün Tuba Yılmaz Esencan Yeliz Doğan Merih

https://doi.org/10.5152/JANHS.2023.23314

Öz

Objective: This study was carried out to examine the frequency of lumbopelvic pain in pregnant women, the level of disability associated with it, and the factors that may affect the level of disability.

Methods: The descriptive, cross-sectional and analytical study was carried out with 381 pregnant women who received service from the routine pregnancy follow-up outpatient clinic of a state
hospital. A form including demographic, obstetric, and other descriptive characteristics of the cases, a visual pain zone diagram to determine the pain area, and the Roland–Morris Disability
Questionnaire (RMDQ) to determine the disability level were used as data collection tools. Descriptive statistical methods and non-parametric tests were used in the analysis of the data.

Results: It was determined that 86.35% (n=329) of the participants had lumbopelvic pain and were mildly disabled according to the RMDQ total score (12.0 ± 7.3). In the analysis performed
according to subgroups, the mean RMDQ scores of pregnant women with pelvic girdle pain were found to be statistically significantly higher than those with low back pain (P < .05). Other variables associated with high disability scores were education level, parity, occupation, gestational week (trimester), presence of lumbopelvic pain in the previous pregnancy, work stress, and negative sexual life history (P < .05).

Conclusion: Lumbopelvic pain is a condition that is common in pregnancy, can cause different levels of disability depending on some factors, and should not be ignored by antenatal care
providers.

Anahtar Kelimeler

Pregnancy lumbopelvic pain disability

Kaynakça

  • 1. Gutke A, Boissonnault J, Brook G, Stuge B. The severity and impact of pelvic girdle pain and low-back pain in pregnancy: a multinational study. J Womens Health (Larchmt). 2018;27(4):510-517. [CrossRef]
  • 2. Liddle SD, Pennick V. Interventions for preventing and treating lowback and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;2015(9):CD001139. [CrossRef]
  • 3. Vyas H. Impact of musculoskeletal dysfunctions on quality of life of pregnant women. IJoNMR. 2020;07(2):27-31. [CrossRef]
  • 4. Aragão FF. Pregnancy-related lumbosacral pain. J Pain. 2019;2(2):176-181. [CrossRef]
  • 5. Vermani E, Mittal R, Weeks A. Pelvic girdle pain and low back pain in pregnancy : a review. Pain Pract. 2010;10(1):60-71. [CrossRef]
  • 6. Gutke A, Kjellby-Wendt G, Öberg B. The inter-rater reliability of a standardised classification system for pregnancy-related lumbopelvic pain. Man Ther. 2010;15(1):13-18. [CrossRef]
  • 7. Wu WH, Meijer OG, Uegaki K, et al. Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. Eur Spine J. 2004;13(7):575-589. [CrossRef]
  • 8. Vleeming A, Albert HB, Östgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17(6):794-819. [CrossRef]
  • 9. Casagrande D, Gugala Z, Clark SM, Lindsey RW. Low back pain and pelvic girdle pain in pregnancy. J Am Acad Orthop Surg. 2015;23(9):539-549. [CrossRef]
  • 10. Gutke A, Olsson CB, Völlestad N, Öberg B, Wikmar LN, Robinson HS. Association between lumbopelvic pain, disability and sick leave during pregnancy - A comparison of three Scandinavian cohorts. J Rehabil Med. 2014;46(5):468-474. [CrossRef]
  • 11. Elden H, Lundgren I, Robertson E. Life’s pregnant pause of pain: pregnant women’s experiences of pelvic girdle pain related to daily life: A Swedish interview study. Sex Reprod Healthc. 2013;4(1):29-34. [CrossRef]
  • 12. Padua L, Padua R, Bondì R, et al. Patient-oriented assessment of back pain in pregnancy. Eur Spine J. 2002;11(3):272-275. [CrossRef]
  • 13. Mogren I. Perceived health, sick leave, psychosocial situation, and sexual life in women with low-back pain and pelvic pain during pregnancy. Acta Obstet Gynecol Scand. 2006;85(6):647-656. [CrossRef]
  • 14. Pierce H, Homer CSE, Dahlen HG, King J. Pregnancy-related lumbopelvic pain: listening to Australian women. Nurs Res Pract. 2012;2012:387428. [CrossRef]
  • 15. Wang SM, Dezinno P, Maranets I, Berman MR, Caldwell-AndrewsAA, Kain ZN. Low back pain during pregnancy : prevalence, risk factors, and outcomes. Obstet Gynecol. 2004;104(1):65-70. [CrossRef]
  • 16. Davenport MH, Marchand AA, Mottola MF, et al. Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: A systematic review and meta-analysis. Br J Sports Med. 2019;53(2):90-98. [CrossRef]
  • 17. Sklempe Kokic IS, Ivanisevic M, Uremovic M, Kokic T, Pisot R, Simunic B. Effect of therapeutic exercises on pregnancy-related low back pain and pelvic girdle pain: secondary analysis of a randomized controlled trial. J Rehabil Med. 2017;49(3):251-257. [CrossRef]
  • 18. Mens JMA, Veld YHH, Goudzwaard AP, Pool-Goudzwaard A. Severity of signs and symptoms in lumbopelvic pain during pregnancy. Man Ther. 2012;17(2):175-179. [CrossRef]
  • 19. Roland M, Morris R. A study of the natural history of back pain Part I. Spine. 1983;8(2):141-144. [CrossRef]
  • 20. Küçükdeveci AA, Tennant A, Elhan AH, Niyazoglu H. Validation of the Turkish version of the Roland-Morris Disability Questionnaire for use in low back pain. Spine. 2001;26(24):2738-2743. [CrossRef]
  • 21. Berber MA, Satılmış İG. Characteristics of low back pain in pregnancy, risk factors, and its effects on quality of life. Pain Manag Nurs. 2020;21(6):579-586. [CrossRef]
  • 22. Gutke A, O¨. stgaard HC, O¨ berg BP. Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning. Spine. 2006;31(20):149-155.
  • 23. Mousavi SJ, Parnianpour M, Vleeming A. Pregnancy related pelvic girdle pain and low back pain in an Iranian population. Spine. 2007;32(3):E100-E104. [CrossRef]
  • 24. Kovacs FM, Garcia E, Royuela A, González L, Abraira V, Spanish Back Pain Research Network. Prevalence and factors associated with low back pain and pelvic girdle pain during pregnancy: a multicenter study conducted in the Spanish national health service. Spine. 2012;37(17):1516-1533. [CrossRef]
  • 25. Ramachandra P, Maiya AG, Kumar P, Kamath A. Prevalence of musculoskeletal dysfunctions among Indian pregnant women. J Pregnancy. 2015;2015:437105. [CrossRef]
  • 26. Sencan S, Ozcan-Eksi EE, Cuce I, Guzel S, Erdem B. Pregnancy-related low back pain in women in Turkey: prevalence and risk factors. Ann Phys Rehabil Med. 2018;61(1):33-37. [CrossRef]
  • 27. Wuytack F, O’Donovan M. Outcomes and outcomes measurements used in intervention studies of pelvic girdle pain and lumbopelvic pain: a systematic review. Chiropr Man Therap. 2019;27(1):62. [CrossRef]
  • 28. Bryndal A, Majchrzycki M, Grochulska A, Glowinski S, Seremak-Mrozikiewicz A. Risk factors associated with low back pain among a group of 1510 pregnant women. J Pers Med. 2020;10(2):3-10. [CrossRef]
  • 29. Rabiee M, Sarchamie N. Low back pain severity and related disability in different trimesters of pregnancy and risk factors. Int J Womens Health Reprod Sci. 2018;6(4):438-443. [CrossRef]
  • 30. Persson M, Winkvist A, Dahlgren L, Mogren I. “Struggling with daily life and enduring pain” : A qualitative study of the experiences of pregnant women living with pelvic girdle pain. BMC Pregnancy Childbirth. 2013;13:111. [CrossRef]
  • 31. Turkey Demographic and Health Survey. Hacettepe University of population studies. In: Hacettepe University of Population Studies. Ankara: TR Ministry of Health; 2018. Available at: http://www.hips .hacettepe.edu.tr/tnsa2018/rapor/TNSA2018 _ana_ Rapor.pdf
  • 32. Chang HY, Jensen MP, Yang YL, Lee CN, Lai YH. Risk factors of pregnancy-related lumbopelvic pain: A biopsychosocial approach. J Clin Nurs. 2012;21(9-10):1274-1283. [CrossRef]
  • 33. Bliddal M, Pottegärd A, Kirkegaard H, et al. Association of pre-pregnancy body mass index, pregnancy-related weight changes, and parity with the risk of developing degenerative musculoskeletal conditions. Arthritis Rheumatol. 2016;68(5):1156-1164. [CrossRef]
  • 34. Lardon E, St-laurent A, Babineau V, Descarreaux M, Ruchat S, Babineau V. Lumbopelvic pain, anxiety, physical activity and mode of conception : a prospective cohort study of pregnant women. BMJ Open. 2018;1-11. [CrossRef]
  • 35. Bakker EC, van Nimwegen-Matzinger CW, Ekkel-van der Voorden W, Nijkamp MD, Völlink T. Psychological determinants of pregnancyrelated lumbopelvic pain: A prospective cohort study. Acta Obstet Gynecol Scand. 2013;92(7):797-803. [CrossRef]
  • 36. Bergström C, Persson M, Mogren I. Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy – pain status, self-rated health and family situation. BMC Pregnancy Childbirth. 2014;14:48. [CrossRef]

Gebelikle İlişkili Lumbopelvik Ağrı ve Engellilik: Görünmeyen ve İhmal Edilen Bir Sorun

Yıl 2023, Cilt: 26 Sayı: 2, 99 - 106, 23.06.2023

Hacer Erten Mahmure Aygün Tuba Yılmaz Esencan Yeliz Doğan Merih

https://doi.org/10.5152/JANHS.2023.23314

Öz

Amaç: Bu çalışma, gebelerde lumbopelvik ağrı sıklığını belirlemek, bununla ilişkili engellilik düzeyini ve engellilik düzeyini etkileyebilecek faktörleri incelemek amacıyla yapılmıştır.

Yöntemler: Tanımlayıcı, kesitsel ve analitik tipteki çalışma bir devlet hastanesinin rutin gebelik izlem polikliniğinden hizmet alan 381 gebe ile gerçekleştirilmiştir. Veri toplama aracı olarak olguların demografik, obstetrik ve diğer tanımlayıcı özelliklerini içeren bir form, ağrı bölgesini belirlemek için görsel ağrı bölgesi diyagramı ve engellilik düzeyini belirlemek için Roland–Morris Engellilik
Anketi (RMEA) kullanılmıştır. Verilerin analizinde tanımlayıcı istatistiksel yöntemler ve parametrik olmayan testler kullanılmıştır.

Bulgular: Katılımcıların %86,35'inde (n=329) lumbopelvik ağrı olduğu ve RMEA toplam puanına göre (12,0 ± 7,3) hafif derecede engelli oldukları saptanmıştır. Alt gruplara göre yapılan incelemede
pelvik kuşak ağrısı olan gebelerin RMEA puan ortalamaları bel ağrısı olan gebelere göre istatistiksel olarak anlamlı derecede yüksek bulunmuştur (P < ,05). Yüksek engellilik puanları ile ilişkili diğer
değişkenlerin, eğitim düzeyi, parite, meslek, gebelik haftası (trimaster), önceki gebelikte lumbopelvik ağrı varlığı, iş stresi ve olumsuz cinsel yaşam öyküsü olduğu saptanmıştır (P < ,05).

Sonuç: Lumbopelvik ağrı, gebelikte sık görülen, bazı faktörlere bağlı olarak farklı düzeylerde engelliliğe neden olabilen ve antenatal bakım verenler tarafından göz ardı edilmemesi gereken bir
durumdur.

Anahtar Kelimeler

Gebelik lumbopelvik ağrı engellilik

Kaynakça

  • 1. Gutke A, Boissonnault J, Brook G, Stuge B. The severity and impact of pelvic girdle pain and low-back pain in pregnancy: a multinational study. J Womens Health (Larchmt). 2018;27(4):510-517. [CrossRef]
  • 2. Liddle SD, Pennick V. Interventions for preventing and treating lowback and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;2015(9):CD001139. [CrossRef]
  • 3. Vyas H. Impact of musculoskeletal dysfunctions on quality of life of pregnant women. IJoNMR. 2020;07(2):27-31. [CrossRef]
  • 4. Aragão FF. Pregnancy-related lumbosacral pain. J Pain. 2019;2(2):176-181. [CrossRef]
  • 5. Vermani E, Mittal R, Weeks A. Pelvic girdle pain and low back pain in pregnancy : a review. Pain Pract. 2010;10(1):60-71. [CrossRef]
  • 6. Gutke A, Kjellby-Wendt G, Öberg B. The inter-rater reliability of a standardised classification system for pregnancy-related lumbopelvic pain. Man Ther. 2010;15(1):13-18. [CrossRef]
  • 7. Wu WH, Meijer OG, Uegaki K, et al. Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. Eur Spine J. 2004;13(7):575-589. [CrossRef]
  • 8. Vleeming A, Albert HB, Östgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17(6):794-819. [CrossRef]
  • 9. Casagrande D, Gugala Z, Clark SM, Lindsey RW. Low back pain and pelvic girdle pain in pregnancy. J Am Acad Orthop Surg. 2015;23(9):539-549. [CrossRef]
  • 10. Gutke A, Olsson CB, Völlestad N, Öberg B, Wikmar LN, Robinson HS. Association between lumbopelvic pain, disability and sick leave during pregnancy - A comparison of three Scandinavian cohorts. J Rehabil Med. 2014;46(5):468-474. [CrossRef]
  • 11. Elden H, Lundgren I, Robertson E. Life’s pregnant pause of pain: pregnant women’s experiences of pelvic girdle pain related to daily life: A Swedish interview study. Sex Reprod Healthc. 2013;4(1):29-34. [CrossRef]
  • 12. Padua L, Padua R, Bondì R, et al. Patient-oriented assessment of back pain in pregnancy. Eur Spine J. 2002;11(3):272-275. [CrossRef]
  • 13. Mogren I. Perceived health, sick leave, psychosocial situation, and sexual life in women with low-back pain and pelvic pain during pregnancy. Acta Obstet Gynecol Scand. 2006;85(6):647-656. [CrossRef]
  • 14. Pierce H, Homer CSE, Dahlen HG, King J. Pregnancy-related lumbopelvic pain: listening to Australian women. Nurs Res Pract. 2012;2012:387428. [CrossRef]
  • 15. Wang SM, Dezinno P, Maranets I, Berman MR, Caldwell-AndrewsAA, Kain ZN. Low back pain during pregnancy : prevalence, risk factors, and outcomes. Obstet Gynecol. 2004;104(1):65-70. [CrossRef]
  • 16. Davenport MH, Marchand AA, Mottola MF, et al. Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: A systematic review and meta-analysis. Br J Sports Med. 2019;53(2):90-98. [CrossRef]
  • 17. Sklempe Kokic IS, Ivanisevic M, Uremovic M, Kokic T, Pisot R, Simunic B. Effect of therapeutic exercises on pregnancy-related low back pain and pelvic girdle pain: secondary analysis of a randomized controlled trial. J Rehabil Med. 2017;49(3):251-257. [CrossRef]
  • 18. Mens JMA, Veld YHH, Goudzwaard AP, Pool-Goudzwaard A. Severity of signs and symptoms in lumbopelvic pain during pregnancy. Man Ther. 2012;17(2):175-179. [CrossRef]
  • 19. Roland M, Morris R. A study of the natural history of back pain Part I. Spine. 1983;8(2):141-144. [CrossRef]
  • 20. Küçükdeveci AA, Tennant A, Elhan AH, Niyazoglu H. Validation of the Turkish version of the Roland-Morris Disability Questionnaire for use in low back pain. Spine. 2001;26(24):2738-2743. [CrossRef]
  • 21. Berber MA, Satılmış İG. Characteristics of low back pain in pregnancy, risk factors, and its effects on quality of life. Pain Manag Nurs. 2020;21(6):579-586. [CrossRef]
  • 22. Gutke A, O¨. stgaard HC, O¨ berg BP. Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning. Spine. 2006;31(20):149-155.
  • 23. Mousavi SJ, Parnianpour M, Vleeming A. Pregnancy related pelvic girdle pain and low back pain in an Iranian population. Spine. 2007;32(3):E100-E104. [CrossRef]
  • 24. Kovacs FM, Garcia E, Royuela A, González L, Abraira V, Spanish Back Pain Research Network. Prevalence and factors associated with low back pain and pelvic girdle pain during pregnancy: a multicenter study conducted in the Spanish national health service. Spine. 2012;37(17):1516-1533. [CrossRef]
  • 25. Ramachandra P, Maiya AG, Kumar P, Kamath A. Prevalence of musculoskeletal dysfunctions among Indian pregnant women. J Pregnancy. 2015;2015:437105. [CrossRef]
  • 26. Sencan S, Ozcan-Eksi EE, Cuce I, Guzel S, Erdem B. Pregnancy-related low back pain in women in Turkey: prevalence and risk factors. Ann Phys Rehabil Med. 2018;61(1):33-37. [CrossRef]
  • 27. Wuytack F, O’Donovan M. Outcomes and outcomes measurements used in intervention studies of pelvic girdle pain and lumbopelvic pain: a systematic review. Chiropr Man Therap. 2019;27(1):62. [CrossRef]
  • 28. Bryndal A, Majchrzycki M, Grochulska A, Glowinski S, Seremak-Mrozikiewicz A. Risk factors associated with low back pain among a group of 1510 pregnant women. J Pers Med. 2020;10(2):3-10. [CrossRef]
  • 29. Rabiee M, Sarchamie N. Low back pain severity and related disability in different trimesters of pregnancy and risk factors. Int J Womens Health Reprod Sci. 2018;6(4):438-443. [CrossRef]
  • 30. Persson M, Winkvist A, Dahlgren L, Mogren I. “Struggling with daily life and enduring pain” : A qualitative study of the experiences of pregnant women living with pelvic girdle pain. BMC Pregnancy Childbirth. 2013;13:111. [CrossRef]
  • 31. Turkey Demographic and Health Survey. Hacettepe University of population studies. In: Hacettepe University of Population Studies. Ankara: TR Ministry of Health; 2018. Available at: http://www.hips .hacettepe.edu.tr/tnsa2018/rapor/TNSA2018 _ana_ Rapor.pdf
  • 32. Chang HY, Jensen MP, Yang YL, Lee CN, Lai YH. Risk factors of pregnancy-related lumbopelvic pain: A biopsychosocial approach. J Clin Nurs. 2012;21(9-10):1274-1283. [CrossRef]
  • 33. Bliddal M, Pottegärd A, Kirkegaard H, et al. Association of pre-pregnancy body mass index, pregnancy-related weight changes, and parity with the risk of developing degenerative musculoskeletal conditions. Arthritis Rheumatol. 2016;68(5):1156-1164. [CrossRef]
  • 34. Lardon E, St-laurent A, Babineau V, Descarreaux M, Ruchat S, Babineau V. Lumbopelvic pain, anxiety, physical activity and mode of conception : a prospective cohort study of pregnant women. BMJ Open. 2018;1-11. [CrossRef]
  • 35. Bakker EC, van Nimwegen-Matzinger CW, Ekkel-van der Voorden W, Nijkamp MD, Völlink T. Psychological determinants of pregnancyrelated lumbopelvic pain: A prospective cohort study. Acta Obstet Gynecol Scand. 2013;92(7):797-803. [CrossRef]
  • 36. Bergström C, Persson M, Mogren I. Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy – pain status, self-rated health and family situation. BMC Pregnancy Childbirth. 2014;14:48. [CrossRef]
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Doğum ve Kadın Hastalıkları Hemşireliği, Hemşirelik (Diğer)
Bölüm Araştırma Makaleleri
Yazarlar

Hacer Erten Bu kişi benim 0000-0001-8965-1384

Mahmure Aygün Bu kişi benim 0000-0003-0753-6783

Tuba Yılmaz Esencan 0000-0002-8748-0793

Yeliz Doğan Merih 0000-0002-6112-0642

Yayımlanma Tarihi 23 Haziran 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 26 Sayı: 2

Kaynak Göster

AMA Erten H, Aygün M, Yılmaz Esencan T, Doğan Merih Y. Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. Journal of Nursology. Haziran 2023;26(2):99-106. doi:10.5152/JANHS.2023.23314
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