Risk factors for pregnancy-related pelvic girdle pain: a scoping review
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(2020) 20:739
RESEARCH ARTICLE
Open Access
Risk factors for pregnancy-related pelvic girdle pain: a scoping review Francesca Wuytack* , Cecily Begley and Deirdre Daly
Abstract Background: Pregnancy-related Pelvic Girdle Pain (PPGP) is a common complaint. The aetiology remains unclear and reports on risk factors for PPGP provide conflicting accounts. The aim of this scoping review was to map the body of literature on risk factors for experiencing PPGP. Methods: We searched the databases PubMed, Embase, CINAHL, PsycINFO, MIDIRS, and ClinicalTrial.gov (3 August 2020). We selected studies with two reviewers independently. Observational studies assessing risk factors for PPGP were included. Studies examining specific diagnostic tests or interventions were excluded. Results: We identified 5090 records from databases and 1077 from ClinicalTrial.gov. Twenty-four records met the inclusion criteria. A total of 148 factors were examined of which only 14 factors were examined in more than one study. Factors that were positively associated with PPGP included a history of low back or pelvic girdle pain, being overweight/obese, already having a child, younger age, lower educational level, no pre-pregnancy exercise, physically demanding work, previous back trauma/disease, progestin-intrauterine device use, stress, depression and anxiety. Conclusions: A large number of factors have been examined as potential risk factors for PPGP, but there is a lack of repetition to be able to draw stronger conclusions and pool studies in systematic reviews. Factors that have been examined in more than five studies include age, body mass index, parity and smoking. We suggest a systematic review be conducted to assess the role of these factors further in the development of PPGP. Keywords: Pelvic girdle pain, Risk factors, Pregnancy, Scoping review
Background Pelvic girdle pain has been described as pain experienced between the posterior iliac crest (inferior to L5) and the inferior gluteal folds, particularly near the sacroiliac joints, and pain may radiate in the posterior thigh and can occur in conjunction with or separate from pain in the symphysis [1] (pp797). Women commonly experience pelvic girdle pain during pregnancy, with reported prevalence of Pregnancy-related Pelvic Girdle Pain (PPGP) ranging from 23 to 65% depending on the study methods used [2–4]. Women with PPGP often have impaired mobility, with 7 to 12.5% having to use crutches * Correspondence: [email protected] School of Nursing & Midwifery, Trinity College Dublin, 24 D’Olier Street, Dublin 2, Ireland
or a wheelchair [5–7]. PPGP symptoms affect their ability to cope with everyday life for which they feel unprepared and which they feel is not acknowledged [8–10]. PPGP is also a leading cause of sick leave during pregnancy [11–13]. The aetiology of PPGP remains uncertain but hormonal and mechanical factors have been suggested. Regarding hormonal factors, the main focus has been on the hormone relaxin, which is thought to increase pelvic laxity, yet evidence from clinical studies
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