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Cited by 79Pregnancy-related medical researchMaternal Mental Health During Pregnancy and PostpartumMusculoskeletal pain and rehabilitation

The comorbidity of low back pelvic pain and risk of depression and anxiety in pregnancy in primiparous women

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Virgara, Rosa, Maher, Carol, Van Kessel, Gisela·2018·BMC Pregnancy and Childbirth
DOI 10.1186/s12884-018-1929-4PMC PMC6032543
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Abstract

BACKGROUND: Approximately 50% of Australian women experience low back pain in pregnancy, with somewhere between 8 and 36% of women suffering from pregnancy related depression/anxiety. Both low back and pelvic pain and depression and anxiety are associated with poor maternal health outcomes, including increased sick leave, higher rates of functional disability, and increased access to healthcare. It also impacts upon time and mode of delivery with an increase in inductions and elective caesarean sections. For babies of women with depression and anxiety preterm birth, low birth weight and intrauterine growth restriction are all common complications. Given these poor health outcomes, it is important to determine the co-morbidity of low back and pelvic pain and depression/anxiety in pregnancy. METHODS: A cross sectional study of a hospital based sample of 96 nulliparous women were assessed at 28 weeks as part of their routine antenatal appointment. Data was collected via interview and clinical records and included the Edinburgh Depression Scale (EDS), the Numerical Rating Scale (NRS) and the Modified Oswestry Low Back Pain Disability Questionnaire (MODQ). Spearman's correlation co-efficients, prevalence ratios and ANOVA were used to determine comorbidity. RESULTS: 96 women consented to participation in the study. All study outcomes were moderately correlated. There were three main findings: One, there was a positive correlation between low back and pelvic girdle pain (LBPP) and depression/anxiety was rho = 0.39, p < 0.001, between LBPP and functional disability was rho = 0.51, p < 0.001 and between risk of depression/anxiety and functional disability was rho = 0.54, p < 0.001. Two, a woman with LBPP was 13 times more likely to have increased risk of depression/anxiety, whilst a woman with increased risk of depression/anxiety was 2.2 times more likely to have LBPP and finally three, amongst women who reported LBPP, the level of disability experienced was significantly higher in women who had concurrent increased risk of depression/anxiety (p = 0.003). This occurred even though the severity of pain did not differ between groups (NRS score mean p = 0.38). CONCLUSIONS: This study found a high level of co-occurrence of LBPP, functional disability and depression/anxiety in women in their third trimester of pregnancy. Importantly women who reported higher depression/anxiety symptoms appeared to experience higher levels of functional disability in relation to their LBPP, than women with lower depression/anxiety symptoms and LBPP.

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  • Maternal anxiety may lead to adverse effects of the newborns, like low birth weight, growth restriction or low APGAR score.

    “What is more, maternal anxiety may lead to adverse effects of the newborns, like low birth weight, growth restriction or low APGAR score [ Abazarnejad T et al., 2019; Virgara R et al.,2018 ].”

    From MINDFULNESS-BASED COGNITIVE THERAPY ON ANXIETY OF PREGNANT WOMEN DURING THE COVID-19 OUTBREAK IN TEHRAN, IRAN (2025) · cites this paper as Virgara R et al., 2018

    The Background (page not provided) links antenatal depression and/or anxiety with low birth weight and intrauterine growth restriction. It does not mention a low APGAR score, so that example is not supported by this source. (LLM, conf=0.88)

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  1. [1]Pierce H, Homer CSE, Dahlen HG, King J. Pregnancy related lumbopelvic pain: listening to Australian women. Nurs Res Prac. 2012; 10.1155/2012/387428. PMC3366229 22685643 · DOI
  2. [2]Vermani E Mittal R Weeks A Pelvic girdle pain and low back pain in pregnancy: a review Pain Pract 2010 10 60 71 10.1111/j.1533-2500.2009.00327.x 19863747 · DOI
  3. [3]Kovacs FM Garcia E Royuela A Gonzalez L Abraira V Prevalence and factors associated with low back and pelvic girdle pain during pregnancy: a multicentre study conducted in the Spanish National Health Service Spine 2012 37 1516 1533 10.1097/BRS.0b013e31824dcb74 22333958 · DOI
  4. [4]Verstraete EH Vanderstraeten G Parewijck W Pelvic girdle pain during or after pregnancy: a review of recent evidence and a clinical care path proposal Obstet Gynecol 2013 5 33 43 PMC3987347 24753927
  5. [5]Gutke A Josefsson A Oberg B Pelvic girdle pain and lumbar pain in relation to postpartum depressive symptoms Spine 2007 32 1430 1436 10.1097/BRS.0b013e318060a673 17545912 · DOI
  6. [6]Robinson HS Velerod MB Mengshoel AM Vollestad N Pelvic girdle pain – associations between risk factors in early pregnancy and disability or pain intensity in late pregnancy: a prospective cohort study BMC Musculoskelet Disord 2010 11 91 10.1186/1471-2474-11-91 20465798 PMC2890600 · DOI
  7. [7]Katonis P Kampourglou A Aggelopoulos A Kakavelakis K Lykoudis S Makrigiannakis A Pregnancy-related low back pain Hippokratia 2011 15 205 210 22435016 PMC3306025
  8. [9]Misri S Kendrick K Oberlander TF Norris S Tomfohr L Zhang H Antenatal depression and anxiety affect postpartum parenting stress: a longitudinal, prospective study Can J Psychiatr 2010 55 222 228 10.1177/070674371005500405 20416145 · DOI
  9. [10]Andersson L Sundstrom-Poromaa I Wulff M Astrom M Bixo M Neonatal outcome following maternal antenatal depression and anxiety: a population based study Am J Epidemiol 2004 159 872 881 10.1093/aje/kwh122 15105180 · DOI
  10. [11]Bowen A Muhajarine N Antenatal depression Can Nur 2006 102 26 30 17168096
  11. [14]Qiao Y Wang J Li J Wang J Effects of depressive and anxiety symptoms during pregnancy on pregnant, obstetric and neonatal outcomes: a follow up study J Obstet Gynaecol 2012 32 237 240 10.3109/01443615.2011.647736 22369395 · DOI
  12. [16]Paschetta E Berrisford G Coccia F Whitmore J Wood AG Pretlove S Perinatal psychiatric disorders: an overview Am J Obstet and Gynecol 2014 210 501 509 10.1016/j.ajog.2013.10.009 24113256 · DOI
  13. [18]Brunton RJ Dryer R Saliba A Kohlhoff J Pregnancy anxiety: a systematic review of current scales J Affect Disord 2015 176 24 34 10.1016/j.jad.2015.01.039 25687280 · DOI
  14. [19]Bakker EC Van Nimwegen-Matzinger CW Ekkel-Van Der Voor-den W MD N Vollink T Psychological determinants of pregnancy-related lumbo-pelvic pain: a prospective cohort study Acta Obstet Gynecol Scand 2013 92 797 803 10.1111/aogs.12131 23465064 · DOI
  15. [20]Robinson HS Mengshoel AM Veierod MB Vollestad N Pelvic girdle pain: potential risk factors in pregnancy in relation to disability and pain intensity three months post partum Man Ther 2010 15 522 528 10.1016/j.math.2010.05.007 20621546 · DOI
  16. [22]Vleeming A Albert HB Ostgaard HC Sturesson B Stuge B European guidelines for the diagnosis and treatment of pelvic girdle pain Eur Spine J 2008 17 794 819 10.1007/s00586-008-0602-4 18259783 PMC2518998 · DOI
  17. [24]Bijur PE Latimer CT Gallagher EJ Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department Acad Emerg Med 2008 10 390 392 10.1197/aemj.10.4.390 12670856 · DOI
  18. [25]Gutke A Ostgaard HC Berg BO Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning Spine 2006 31 E149 E155 10.1097/01.brs.0000201259.63363.e1 16508539 · DOI
  19. [26]Kernot J Olds T Lewis LK Maher C Test-retest reliability of the English version of the Edinburgh postnatal depression scale Arch Womens Ment Health 2015 18 255 257 10.1007/s00737-014-0461-4 25209355 · DOI
  20. [27]Bergink V Kooistra L Lambregtse-van den Berga MP Wijnen H Bunevicius R van Baar A Validation of the Edinburgh depression scale during pregnancy J Psychosom Res 2011 70 385 389 10.1016/j.jpsychores.2010.07.008 21414460 · DOI · Paper page
  21. [29]Cleland JA Whitman JM Houser JL Wainner RS Childs JD Psychometric properties of selected tests in patients with lumbar spinal stenosis Spine J 2012 12 921 931 10.1016/j.spinee.2012.05.004 22749295 · DOI
  22. [30]Davidson M Keating JL A comparison of 5 low back disability questionnaires: reliability and responsiveness Phys Ther 2002 82 8 24 10.1093/ptj/82.1.8 11784274 · DOI
  23. [31]Arnow B Hunkeler E Blasey CM Lee J Constantino MJ Fireman B Comorbid depression, chronic pain and disability in primary care Psychosom Med 2006 68 262 268 10.1097/01.psy.0000204851.15499.fc 16554392 · DOI
  24. [32]Smith RC Fortin AH Dwamena F Frankel RM An evidence-based patient-centred method make the biopsychosocial model scientific Patient Educ and Couns 2013 91 265 270 10.1016/j.pec.2012.12.010 23352913 · DOI
  25. [33]Woby SR Roach NK Urmston M Watson PJ The relation between cognitive factors and levels of pain and disability in chronic low back pain patients presenting for physiotherapy Eur J Pain 2007 11 869 877 10.1016/j.ejpain.2007.01.005 17360202 · DOI

Cited by

Sorted by citations

Authors
Virgara, R., Maher, C., & Van Kessel, G.
Affiliations
University of South Australia (AU)
Corresponding author
Virgara, Rosa
ORCID
Venue
BMC Pregnancy and Childbirth
Publisher
Springer Science and Business Media LLC
Published
2018-07-04
Volume
18
Issue
1
Pages
288-288
ISSN
1471-2393 (ISSN-L)
DOI
10.1186/s12884-018-1929-4
PMC
PMC6032543
OpenAlex
W2811042691
Cited by
79
References
8
Citations by year
2026: 5 · 2025: 11 · 2024: 9 · 2023: 19 · 2022: 7 · 2021: 15 · 2020: 11 · 2019: 2
FWCI
6.67
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Pregnancy and Childbirth (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UniSA Research Outputs Repository (University of South Australia) (acceptedVersion, cc-by)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Health and Medical Research Council
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
pregnancy, depression, anxiety, comorbidities, primiparous women, functional disability, low back pain disability, third trimester, maternal mental health, prenatal care
MeSH terms
Adult, Anxiety, Australia, Cesarean Section, Cross-Sectional Studies, Depression, Female, Humans, Parity, Pregnancy, Pregnancy Complications, Risk Factors, Comorbidity, Prevalence, Low Back Pain, Sick Leave, Pelvic Girdle Pain

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