Low Back Pain during Pregnancy and Delivery Outcomes
Arrigo Fruscalzo, Paolo Cocco, Ambrogio P. Londero, Markus Gantert
Abstract
AIM: To evaluate low back pain (LBP) incidence and impact throughout pregnancy in terms of women's well-being and delivery outcomes. MATERIAL AND METHODS: Cross-sectional prospective study conducted on singleton pregnancies at ≥37th gestational age admitted for delivery. Localization of LBP, intensity and frequency as well as derived functional disability status were assessed with a self-reported questionnaire. Main delivery outcomes including mode of delivery, and maternal or neonatal complications were recorded. RESULTS: A total of 229 women participated in the study. LBP prevalence amounted to 55.9%, with the pain already present before pregnancy in 14.0% of the cases. The pain was mostly localized in the lower back (40.6%), symphysis (23.3%), and coccyx (20.5%). Both the frequency and intensity of pain gradually increased significantly during pregnancy, reaching 20 days/month (IQR=10-30) and 6/10 points (IQR=5-8) on a visual analog scale in the 3rd trimester (p<0.05). The extent of functional impairment also progressively increased up to 39/100 points (IQR=25-55, p<0.05). Women affected by LBP during pregnancy had a higher cesarean section rate during labor than women without LBP (11.9% vs. 28.9%, p<0.05). The risk was also significant in the multivariate analysis (OR=4.0, 95%CI=1.1-15.0, p<0.05). There was no difference in the rate of operative vaginal births or in the other outcomes considered. CONCLUSIONS: LBP is a common issue in pregnant women, accounting for increasing morbidity and invalidity, and leading to an increased cesarean section risk during labor.