Low-back pain of pregnancy

Low-back pain (LBP) is a commonly observed symptom during pregnancy. Despite its high frequency the extent of the problem is less well documented and detailed studies concerning related risk factors are scarce. Furthermore, efforts to address the problem are hampered by the inability to predict accurately which pregnancies are at risk. This study was conducted in order to assess the frequency, manifestations and the contribution of various factors to the development of LBP during pregnancy.

The study included 449 pregnant women who were consecutively referred for an antenatal ultrasonographic examination for various reasons. A simple questionnaire which consisted of several items along with ultrasonographic measurements was devised to evaluate the incidence of and risk factors for LBP during pregnancy.

246 (54.8%) women reported LBP in the present pregnancy. Factors which were found to be significantly associated with an increased risk to develop LBP during pregnancy included low socioeconomic class, existence of LBP before the first pregnancy, during previous pregnancy, and interim pregnancies. Moreover, in nulliparous women, body mass index (BMI) was found to be significantly higher in women suffering from LBP. A tendency was observed between posterior/fundal location of the placenta to the presence of LBP during pregnancy. This tendency was also observed among parous but not among nulliparous women. Among pregnant women with LBP, pain radiation correlated significantly to fetal weight. Moreover, this correlation was also of statistical significance in nulliparous women with anterior placental location. Back care advice given to women suffering from LBP was found to significantly reduce LBP. The age, number of prior pregnancies, gestational age, average maternal height, weight and BMI were not found to be risk factors in LBP. Furthermore, we found no influence of previous abortion/s, instrumental delivery, previous cesarean section, or a history of epidural anesthesia during a previous labor were risks to develop LBP in the subsequent pregnancy.

In the present pregnancy, LBP during pregnancy was associated with a history of LBP various socioanthropometric measures, as well as several ultrasonographic and obstetrical data. Back care advice offered to pregnant women who are prone to develop LBP during pregnancy, as early in their pregnancy as possible, may prevent or result in less 'troublesome' and 'severe' LBP during pregnancy.