Prevalence and severity of low back- and pelvic girdle pain in pregnant Nepalese women

Ranjeeta Shijagurumayum Acharya; Anne Therese Tveter; Margreth Grotle; Malin Eberhard-Gran; Britt Stuge

doi:10.1186/s12884-019-2398-0

Prevalence and severity of low back- and pelvic girdle pain in pregnant Nepalese women

BMC Pregnancy Childbirth. 2019 Jul 15;19(1):247. doi: 10.1186/s12884-019-2398-0.

Authors

Ranjeeta Shijagurumayum Acharya^{1

2

3}, Anne Therese Tveter^{4

5}, Margreth Grotle^{4

6}, Malin Eberhard-Gran^{7

8

9}, Britt Stuge¹⁰

Affiliations

¹ Department of Physiotherapy, Kathmandu University School of Medical Sciences, Kathmandu University Dhulikhel Hospital, Kavre, Nepal. ranjeetashija@gmail.com.
² Institute of Clinical Medicine, University of Oslo, Oslo, Norway. ranjeetashija@gmail.com.
³ Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway. ranjeetashija@gmail.com.
⁴ Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
⁵ National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
⁶ FORMI, Oslo University Hospital, Oslo, Norway.
⁷ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁸ Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.
⁹ Department for Infant Mental Health, Regional Center for Child and Adolescent Mental Health, Oslo, Eastern and Southern Norway, Norway.
¹⁰ Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.

Abstract

Background: Low back pain (LBP) and pelvic girdle pain (PGP) are commonly reported during pregnancy and are known to affect pregnant women's well-being. Still, these conditions are often considered to be a normal part of pregnancy. This study assesses the prevalence and severity of LBP and/or PGP among pregnant Nepalese women, as well as exploring factors associated with LBP and PGP.

Methods: A cross-sectional study with successive recruitment of pregnant women was conducted at two district hospitals in Nepal from May 2016 to May 2017. The data was collected using self-reported questionnaires. Univariate and multivariate logistic regression were used to assess the associations between independent variables and LBP and/or PGP.

Results: A total of 1284 pregnant women were included in the study. The reported prevalence of pregnancy-related LBP and/or PGP was 34%. Pain intensity was high with a mean score (standard deviation) of 6 (2). The median (25th-75th percentiles) disability scores according to the total Pelvic Girdle Questionnaire and Oswestry Disability Index were 20 (10-32) and 30 (21-38), respectively. Even though only 52% of the women believed that the pain would disappear after delivery, concern about LBP and/or PGP was reported to be low (median 2 (0-4) (Numeric Rating Scale 0-10)). In the final model for women with LBP and/or PGP the adjusted odds ratios were for body mass index (20-24, 25-30, > 30) 0.7 (95% confidence interval (CI), 0.44-1.21), 1.1 (95% CI, 0.66-1.83), and 1.5 (95% CI, 0.78-2.94) respectively, for pelvic organ prolapse symptoms 6.6 (95% CI, 4.93-8.95) and for women with educated husbands (primary or secondary, higher secondary or above) 1.1 (95% CI, 0.53-2.16) and 1.7 (95% CI, 0.84-3.47), respectively.

Conclusions: Pregnant Nepalese women commonly report LBP and/or PGP. The women experienced low disability despite severe pain intensity and poor beliefs in recovery after delivery.

Keywords: Function; Impact; Low back pain; Nepal; Pelvic girdle pain; Pelvic pain; Pregnancy; Prevalence; Severity; Women’s health.

MeSH terms

Adult
Cross-Sectional Studies
Female
Humans
Logistic Models
Low Back Pain / epidemiology*
Nepal / epidemiology
Pelvic Girdle Pain / epidemiology*
Pregnancy
Pregnancy Complications / epidemiology*
Prevalence
Risk Factors
Self Report
Severity of Illness Index