Yıl: 2023 Cilt: 26 Sayı: 2 Sayfa Aralığı: 99 - 106 Metin Dili: İngilizce DOI: 10.5152/JANHS.2023.23314 İndeks Tarihi: 23-07-2023

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

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 differ ent levels of disability depending on some factors, and should not be ignored by antenatal care providers.
Anahtar Kelime:

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

Öz:
Amaç: Bu çalışma, gebelerde lumbopelvik ağrı sıklığını belirlemek, bununla ilişkili engellilik düze yini 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 olgula rın 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 istatistik sel olarak anlamlı derecede yüksek bulunmuştur (P < ,05). Yüksek engellilik puanları ile ilişkili diğer değişkenlerin, eğitim düzeyi, parite, meslek, gebelik haftası (trimaster), önceki gebelikte lumbo pelvik 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 Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Gutke A, Boissonnault J, Brook G, Stuge B. The severity and impact of pelvic girdle pain and low-back pain in pregnancy: a multina tional study. J Womens Health (Larchmt). 2018;27(4):510-517. [CrossRef]
  • 2. Liddle SD, Pennick V. Interventions for preventing and treating low back 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 lumbopel vic 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 dur ing pregnancy - A comparison of three Scandinavian cohorts. J Reha bil Med. 2014;46(5):468-474. [CrossRef]
  • 11. Elden H, Lundgren I, Robertson E. Life’s pregnant pause of pain: preg nant 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 lum bopelvic 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 pre vention 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, Simu nic B. Effect of therapeutic exercises on pregnancy-related low back pain and pelvic girdle pain: secondary analysis of a randomized con trolled 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 mus culoskeletal dysfunctions among Indian pregnant women. J Preg nancy. 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-Mro zikiewicz 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 Child birth. 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 preg nancy-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-preg nancy body mass index, pregnancy-related weight changes, and par ity 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 pregnancy related 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]
APA ERTEN H, Aygün M, YILMAZ ESENCAN T, DOGAN MERİH Y (2023). Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. , 99 - 106. 10.5152/JANHS.2023.23314
Chicago ERTEN Hacer,Aygün Mahmure,YILMAZ ESENCAN Tuğba,DOGAN MERİH Yeliz Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. (2023): 99 - 106. 10.5152/JANHS.2023.23314
MLA ERTEN Hacer,Aygün Mahmure,YILMAZ ESENCAN Tuğba,DOGAN MERİH Yeliz Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. , 2023, ss.99 - 106. 10.5152/JANHS.2023.23314
AMA ERTEN H,Aygün M,YILMAZ ESENCAN T,DOGAN MERİH Y Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. . 2023; 99 - 106. 10.5152/JANHS.2023.23314
Vancouver ERTEN H,Aygün M,YILMAZ ESENCAN T,DOGAN MERİH Y Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. . 2023; 99 - 106. 10.5152/JANHS.2023.23314
IEEE ERTEN H,Aygün M,YILMAZ ESENCAN T,DOGAN MERİH Y "Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem." , ss.99 - 106, 2023. 10.5152/JANHS.2023.23314
ISNAD ERTEN, Hacer vd. "Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem". (2023), 99-106. https://doi.org/10.5152/JANHS.2023.23314
APA ERTEN H, Aygün M, YILMAZ ESENCAN T, DOGAN MERİH Y (2023). Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. Journal of nursology (Online), 26(2), 99 - 106. 10.5152/JANHS.2023.23314
Chicago ERTEN Hacer,Aygün Mahmure,YILMAZ ESENCAN Tuğba,DOGAN MERİH Yeliz Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. Journal of nursology (Online) 26, no.2 (2023): 99 - 106. 10.5152/JANHS.2023.23314
MLA ERTEN Hacer,Aygün Mahmure,YILMAZ ESENCAN Tuğba,DOGAN MERİH Yeliz Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. Journal of nursology (Online), vol.26, no.2, 2023, ss.99 - 106. 10.5152/JANHS.2023.23314
AMA ERTEN H,Aygün M,YILMAZ ESENCAN T,DOGAN MERİH Y Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. Journal of nursology (Online). 2023; 26(2): 99 - 106. 10.5152/JANHS.2023.23314
Vancouver ERTEN H,Aygün M,YILMAZ ESENCAN T,DOGAN MERİH Y Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem. Journal of nursology (Online). 2023; 26(2): 99 - 106. 10.5152/JANHS.2023.23314
IEEE ERTEN H,Aygün M,YILMAZ ESENCAN T,DOGAN MERİH Y "Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem." Journal of nursology (Online), 26, ss.99 - 106, 2023. 10.5152/JANHS.2023.23314
ISNAD ERTEN, Hacer vd. "Pregnancy-Related Lumbopelvic Pain and Disability: An Invisible and Neglected Problem". Journal of nursology (Online) 26/2 (2023), 99-106. https://doi.org/10.5152/JANHS.2023.23314