Possible Predictive Factors for Low Back and Pelvic Pain at Three Months Postpartum Assessed in a Prospective Study from Early Pregnancy until the Postpartum Period

Background: Low back and pelvic pain (LBPP) is an important issue related to mental health as well as to difficulty for daily life activity during early pregnancy and in the postpartum period. We examined the intensity of LBPP, difficulty for daily life activity and mental health and their associations from early pregnancy until 3 months postpartum in a prospective study. We also examined predictive factors for LBPP at 3 months postpartum. Methods: We recruited 55 pregnant women who responded to questionnaires in the first, second and third trimesters and at one week, one month and 3 months postpartum. We designed a self-administered questionnaire including a visual analog scale (VAS), pregnancy mobility index (PMI) of LBPP and Edinburgh postnatal depression scale (EPDS). Results: There were significant differences in the proportions of women with LBPP in the first trimester (63.6%), second trimester (78.2%) and third trimester (83.6%) and at one week postpartum (80.0%), one month postpartum (69.1%) and 3 months postpartum (56.4%). VAS score at 3 months postpartum was significantly correlated with VAS scores at the first trimester (r = 0.410, p = 0.002), second trimester (r = 0.298, p = 0.027) and one month postpartum (r = 0.476, p < 0.001). VAS score at 3 months postpartum was significantly correlated with PMI scores at the first trimester and one month postpartum. The presence of LBPP at 3 months postpartum was significantly associated with the proportion of women with LBPP at the first trimester. In multiparous women, predictive factor of LBPP at 3 months postpartum was a past history of LBPP in the previous pregnancy. Conclusion: The proportion of women with LBPP and the intensity of LBPP were increased at late pregnancy and gradually decreased until 3 months postpartum. LBPP at 3 months postpartum was associated with LBPP at the first trimester and a past history of LBPP in a previous pregnancy was an important factor for prediction of LBPP at 3 months postpartum. Provision of information regarding LBPP and confirmation of LBPP before pregnancy in addition to assessment of LBPP at early pregnancy are necessary for reduction of LBPP at 3 months postpartum.

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本論文は，著者Yuko Uemuraの学位論文として提出され，学位審査・授与の対象となっている。

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