Abstract
BackgroundPelvic girdle pain (PGP) is common during pregnancy but the causes remain poorly understood. Generalized joint hypermobility (GJH) is an inherited trait, with joint mobility beyond normal limits and is assumed to be related with PGP. The aim of this project was to study the association between self-reported GJH and the presence of PGP during pregnancy.MethodsIn this cohort study, 4884 Swedish-speaking women were consecutively recruited at their first visit for registration in the national antenatal screening programme in Sweden. We used the five-part questionnaire (5PQ) to assess GJH and pain drawings to identify PGP. Our primary outcome was the presence of PGP during the entire pregnancy and secondary outcomes were PGP in each trimesters. We tested the associations with logistic regression analysis, and adjusted for age and ethnicity.ResultsIn all, 2455 (50.3%) women responded to both questionnaires. The prevalence of self-reported GJH was 28.7%. A higher proportion of women with GJH than women without GJH reported PGP during the entire pregnancy (47.9% vs. 41.0%), particularly in trimester 1 (31.6% vs. 22.0%). Thus, women with GJH also had higher odds of PGP during the entire pregnancy (adjusted odds ratio (aOR) 1.27: 95% CI 1.11–1.47) and in trimester 1 (aOR 1.54: 95% CI 1.20–1.96), but the associations were not statistically significant in trimester 2 (aOR 1.24: 95% CI 0.82–1.88) or trimester 3 (aOR 1.20: 95% CI 0.99–1.45). The odds of PGP in pregnancy increased with increasing numbers of positive answers to the 5PQ (p for linear trend < 0.001) for the entire pregnancy and in trimester 1 (p for linear trend < 0.001), but not in trimesters 2 or 3 (p = 0.13 and p = 0.06, respectively).ConclusionsCompared to women with normal joint mobility, women with GJH had higher odds of reporting PGP during pregnancy and the odds increased with number of positive responses to the 5PQ. The associations were present in trimester 1 but did not reach statistical significance in trimester 2 and 3.
Highlights
Pelvic girdle pain (PGP) is common during pregnancy but the causes remain poorly understood
Women with Generalized joint hypermobility (GJH) more often had an origin outside Europe, had lower education levels and more often had experienced back pain before pregnancy compared with women without GJH (Table 1)
Among women classified with GJH, the questions “Can you place your hands flat on the floor without bending your knees?” and “As a child did you amuse your friends by contorting your body into strange shapes or could you do the split?”, were those most frequently answered positively, corresponding to 76.9% (n = 490) and 72.1% (n = 459), respectively
Summary
Pelvic girdle pain (PGP) is common during pregnancy but the causes remain poorly understood. Generalized joint hypermobility (GJH) is an inherited trait, with joint mobility beyond normal limits and is assumed to be related with PGP. The aim of this project was to study the association between self-reported GJH and the presence of PGP during pregnancy. Pelvic girdle pain (PGP) is a common condition during pregnancy [1] with a reported nine-month prevalence of 50% [2, 3]. The pelvic joints may be more vulnerable to load and prone to pain development, especially in people with fragile connective tissue [14,15,16]. Constitutional weakness of the connective tissue may be reflected by increased peripheral joint mobility [17]
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