The Role of Proprioceptive Deficits, Psychosocial Factors and Inflammation in Pregnancy-related Pelvic Girdle Pain

The Role of Lumbar Proprioceptive Deficits, Psychosocial Factors and Inflammation in Pregnancy-related Pelvic Girdle Pain: a Follow-up Study in Multiparous Pregnant Women

A large proportion of pregnant women develop pregnancy-related low back and/or pelvic girdle pain (PPGP), which often does not recover spontaneously postpartum. As a result, 10% of women with PPGP are thus crucial. However, the underlying mechanisms of PPGP are still poorly understood. The main objective of this study is to investigate whether lumbar proprioceptive deficits, a disturbed body perception at the lumbar spine, psychosocial factors (incl. pain-related fear of movement, depression, anxiety and stress) and increased serum concentrations of specific inflammatory mediators are associated with (1) a reduced postural control and (2) the development and/or persistence of PPGP in multiparous women during the first and third trimester of pregnancy, and six weeks and six months postpartum.

Inclusion Criteria Multiparous Women:

• Singleton pregnancy
• Pregnant of second child or more than second child
• No current PPGP or did not have PPGP during current pregnancy
• Willing to provide written informed consent

Exclusion Criteria Multiparous Women:

• Pregnant for more than 16 weeks
• Having current PPGP or having had PPGP during the current pregnancy
• History of surgery/major trauma to spine or pelvis
• Surgery/physical trauma to the lower limbs more than two years ago and currently still experiencing symptoms such as pain, instability, or stiffness
• Surgery/physical trauma to the lower limbs less than two years ago
• Specific balance or vestibular disorders
• A medical diagnosis of a rheumatic condition or being under treatment for such a condition by a rheumatologist
• Neurological abnormalities (e.g., peripheral neuropathy)
• Uncorrected visual problems
• Acute ankle problems
• Being on absolute or relative bed rest due to pregnancy-related complications
• Having (had) a formal diagnosis of a psychiatric disorder
• Non-Dutch speaking

Inclusion Criteria Nulliparous Women:

• Age- and BMI- matched to pregnant participants
• Nulliparous
• Willing to provide written informed consent

Exclusion Criteria Nulliparous Women:

• Having low back or pelvic girdle pain at the time of inclusion or in the six months leading up to inclusion
• History of chronic low back or pelvic girdle pain
• History of surgery/major trauma to spine, pelvis and/or lower limbs,
• Specific balance or vestibular disorders
• Spinal deformities
• Rheumatic disease
• Neurological abnormalities
• Acute ankle problems
• (A history of) psychiatric disorders
• Uncorrected visual problems
• Non-Dutch speaking