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Prevalence of pregnancy-related pelvic girdle pain and associated factors in Australia: a cross-sectional study protocol.

ABSTRACT: INTRODUCTION:Pregnancy-related pelvic girdle pain (PPGP) is a common musculoskeletal disorder. Women with PPGP report difficulty performing everyday functional activities, such as standing and walking. However, the magnitude of the problem remains unknown in Australia. It is important to determine how many women are affected by this condition and the factors associated with PPGP as this will direct healthcare services to being able to better manage women during pregnancy. Thus, this study aims to determine the prevalence of PPGP and associated factors in a Western Sydney population. METHODS AND ANALYSIS:This study is a cross-sectional study to be conducted at a single hospital in Australia. Participants will be over 18 years of age, between 14 and 38 weeks gestation and recruited randomly from all pregnant women attending antenatal care. Participants will have anthropomorphic measures recorded, such as height and body weight, and be asked to complete questionnaires about their current pregnancy, sociodemographic information, ethnoculture, occupational factors and participation in functional activities. The classification of PPGP will be made as per the published guidelines and will include a physical examination. ETHICS AND DISSEMINATION:Ethical approval has been granted by the Human Research Ethics Committees of Westmead Hospital, Sydney, and Western Sydney University, Sydney. Dissemination of results will be via journal articles and conference presentations. TRIAL REGISTRATION NUMBER:ACTRN12617000904370.

SUBMITTER: Ceprnja D

PROVIDER: S-EPMC5695351 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Prevalence of pregnancy-related pelvic girdle pain and associated factors in Australia: a cross-sectional study protocol.

Ceprnja Dragana D Chipchase Lucinda L Gupta Amitabh A

BMJ open 20171115 11

<h4>Introduction</h4>Pregnancy-related pelvic girdle pain (PPGP) is a common musculoskeletal disorder. Women with PPGP report difficulty performing everyday functional activities, such as standing and walking. However, the magnitude of the problem remains unknown in Australia. It is important to determine how many women are affected by this condition and the factors associated with PPGP as this will direct healthcare services to being able to better manage women during pregnancy. Thus, this stud ...[more]

PMID: 29146651

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Project description:Background For many pregnant women, pelvic girdle pain caused by pregnancy has an impact on their daily living. Women with lumbo-pelvic pain have moderate to severe discomfort that makes daily activities like getting out of a chair, bending, and walking difficult. The aim of this study was to determine the extent of daily activity restrictions and to discover predictors of pregnancy-related pelvic girdle pain. Study design Prospective cross-sectional study. Methods This prospective cross-sectional study was undertaken from January October 2018 to October 29/2019 among 337 gravid mothers with pregnancy-related limbo-pelvic pain. A structured questionnaire adapted from the activity limitation-related pelvic girdle pain questionnaire was used for data collection. Epi-info version 7.1 for data entry and STATA version 14 for statistical analysis were used. Ordinal regression with an odds ratio of 95% confidence interval and p-value < 0.05 were cast-off to assess the association between the outcome and dependent variables. Results Among 324 pregnant women with pelvic girdle pain 96 (29.6%) had small extent level of activity limitation, 185 (57.1%) had moderate activity limitation, and 43 (13.3%) large extent level of activity limitation. Having previous children (AOR = 0.37, 95% CI:0.14, 0.98), occupation (AOR = 1.77, 95% CI: 1.06, 2.95) and taking alcohol (AOR = 0.43, 95% CI: 0.19, 0.99) were the independent predictors for activity limitation. Conclusion Nearly one-third of the participants had a modest degree of activity restriction, while more than half of the pregnant women with PPGP had a moderate to high level of restriction. Previous children, occupation, and alcohol consumption were all independent predictors of activity limitation among pregnant women. Highlights • PGP and LBP are commonly reported by pregnant women all over the world.• Women's during pregnancy reported limitations in activities of daily life.• One-third of the pregnant women with PPGP had a modest degree of activity restriction.• More than half of the pregnant women with PPGP had a moderate to high level of restriction.• Having children, occupation, and alcohol consumption were independent predictors of activity limitation.

Project description:IntroductionPelvic girdle pain during and after pregnancy is a major public health problem with significant daily problems for affected women and their families. There is now accumulating evidence that pregnancy-related pelvic girdle pain originates from the sacroiliac joints and the pubic symphysis as well as their extra-articular ligaments. However, the heritability of the disease remains to be determined. We hypothesized that there is an increased familial risk of pregnancy-related pelvic girdle pain.Material and methodsA population-based national database linkage registry study of approximately 9.3 million individuals within 4.2 million families in Sweden with a recruitment period from 1997 to 2018. The Swedish Multi-generation register was used to find female pairs of twins, full siblings, half-siblings and first cousins where both in the pairs had a completed pregnancy. The outcome measure was diagnosis of pregnancy-related pelvic girdle pain (International Classification of Diseases-10 O26.7 [1997-2018]) in the first pregnancy. Data was obtained from the Swedish Hospital Discharge Register, the Swedish Outpatient Care Register, the Swedish Medical Birth Register, the Primary Healthcare Register, and Medical Treatment Register. Cox regression analysis was used to calculate adjusted estimated effect of the exposure variable familial history of pregnancy-related pelvic girdle pain on the outcome variable pregnancy-related pelvic girdle pain at first birth.ResultsFrom the registers, 1 010 064 women pregnant with their first child within 795 654 families were collected. In total, 109 147 women were diagnosed with pregnancy-related pelvic girdle pain. The adjusted hazard ratio for a familial risk of pregnancy-related pelvic girdle pain was 2.09 (95% CI 1.85-2.37) among twins (monozygotic and dizygotic), 1.78 (95% CI 1.74-1.82) in full siblings, 1.16 (95% CI 1.06-1.28) in half-siblings from the mother, 1.09 (95% CI 1.024-1.16) in half-siblings from the father and 1.09 (95% CI 1.07-1.12) in first cousins.ConclusionsThis nationwide observational study showed a familial clustering of pregnancy-related pelvic girdle pain. The hazard ratio for the condition was associated with the degree of relatedness, suggesting that heredity factors contribute to the development of pregnancy-related pelvic girdle pain. There is no causal treatment available for pregnancy-related pelvic girdle pain and further studies are now encouraged to clarify the specific genetic factors that contribute to the disease and for future targeted interventions.

Project description:BackgroundPregnancy-related pelvic girdle pain (PPGP) is a common condition worldwide. Women report being unprepared about PPGP, and state they receive little recognition and support from healthcare professionals. Situated within the Common-Sense Model and Convergent Care Theory, this study sought to gain a conceptual understanding of the perceptions, beliefs and experiences of healthcare professionals who provide routine care for women with PPGP in Australia.MethodsA qualitative research design, using individual, semi-structured interviews with purposive sampling of healthcare professionals (N=27) consisting of doctors (N=9), midwives (N=9) and physiotherapists (N=9). Most participants were female (22/27) with a range of professional experience. An interview guide consisting of open-ended questions was used with a flexible and responsive approach. Thematic analysis was performed where interview data were transcribed, coded, grouped into meaningful categories and then constructed into broad themes.ResultsFour themes were identified: 1. Identity and impact of PPGP; 2. What works well?; 3. What gets in the way?; and 4. Quality care: What is needed? Healthcare professionals recognised PPGP as a common and disabling condition, which created a large impact on a woman's life during pregnancy. Stepped-level care, including education and physiotherapy intervention, was seen to be helpful and led to a positive prognosis. Barriers at patient, clinician and organisation levels were identified and led to consequences for women with PPGP not receiving the care they need.ConclusionThis study elucidates important implications for health care delivery. Acknowledging that PPGP is a common condition causing difficulty for many women, healthcare professionals identified strong teamwork and greater clinical experience as important factors in being able to deliver appropriate healthcare. Whilst healthcare professionals reported being committed to caring for women during pregnancy, busy workloads, attitudes towards curability, and a lack of formal education were identified as barriers to care. The findings suggest timely access, clear referral pathways and an integrated approach are required for best care practice for women with PPGP. A greater emphasis on the need for multidisciplinary models of care during pregnancy is evident.

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Prevalence of pregnancy-related pelvic girdle pain and associated factors in Australia: a cross-sectional study protocol.

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Prevalence of pregnancy-related pelvic girdle pain and associated factors in Australia: a cross-sectional study protocol.

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