Lumbopelvic pain, anxiety, physical activity and mode of conception: a prospective cohort study of pregnant women

OBJECTIVES: Pregnancy-related lumbopelvic pain (LPP) is a frequent condition known to significantly affect women in their daily life. The aetiology of pregnancy-related LPP pain is still not clearly established but the mode of conception has been suggested to contribute to LPP. Anxiety related to fertility treatments may be one of the contributing factors. The primary objectives of this study were to determine the evolution of LPP prevalence and severity, and anxiety throughout pregnancy in women who conceived spontaneously (SP) or after fertility treatments (FT). A further aim was to examine the relationship between pregnancy-related LPP severity and anxiety. The secondary objective was to determine the evolution of physical activity and their correlation with the severity of pregnancy-related LPP. DESIGN: Prospective cohort study. SETTING: Pregnant women were recruited through physicians’ referrals, posters and newspaper advertisements in the local and surrounding communities (hospital, maternity care clinic, prenatal centres, sports centres, local university) in the city of Trois-Rivières, Canada. PARTICIPANTS: 59 pregnant women (33 SP and 26 FT) were assessed during the first, second and third trimester of pregnancy. PRIMARY AND SECONDARY OUTCOME MEASURES: Pregnancy-related LPP prevalence and severity (primary), trait and state anxiety, and physical activity levels (secondary). RESULTS: There was no relationship between the mode of conception and the outcome measures. The prevalence and severity of LPP increased over the course of pregnancy (time effect, p<0.0001) whereas trait anxiety decreased from early to mid-pregnancy (time effect, p=0.03). Activity limitations increased throughout pregnancy (time effect, p<0.0001) and physical activity levels decreased (time effect, p<0.0001). The severity of LPP was positively correlated with activity limitations (r=0.51 to 0.55) but negatively with physical activity levels (r=−0.39 to −0.41). CONCLUSIONS: Maternal health-related factors, such as LPP, anxiety and physical activity, are not different in women who conceived spontaneously or after fertility treatments. The more LPP was severe, the more the women were physically limited and inactive.