Predictors of Postpartum Pelvic Joint Pain Identified Among Working Women

First report of unexplained pain as predictor, according to new study in PAIN®

Philadelphia, PA, December 4, 2012 – A new study of working women has identified factors during pregnancy and postpartum that can predict pain in the joints that comprise the pelvic girdle. While 90 percent of working women in the Netherlands return to work after the birth of their first child, health issues during the postpartum period often require sick leave. Chief among these health issues is pelvic girdle pain (PGP).

“It is important to identify predictors for postpartum PGP, because physicians, obstetricians, midwives, and employers could use them to identify women at risk for PGP and develop and implement preventive measures,” says lead investigator Mireille N.M. van Poppel, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam. “These professionals can also give extra guidance aimed at the prevention of PGP during pregnancy or in the early postpartum period to women at risk for developing postpartum PGP.”

The study team administered surveys to 548 pregnant Dutch employees from 15 companies at three different time intervals: 30 weeks of pregnancy and 6 and 12 weeks postpartum. The survey posed demographic, work-related, pregnancy-related, fatigue, psychosocial, pelvic girdle pain-related, and delivery-related questions. To participate in the study, workers had to work for at least 12 hours per week during their pregnancy, and have the intention to return to work after maternity leave.

The study found that PGP existed among 73 percent of the respondents at 30 weeks of pregnancy, 48 percent between 0 and 6 weeks postpartum and 43 percent between 6 and 12 weeks postpartum. In analyzing the study data, investigators developed two statistical models, one for pregnancy-related predictors and one for pregnancy- and postpartum-related predictors.

The pregnancy model determined that the following can predict PGP at 12 weeks after birth: History of low back pain, higher somatization (a condition in which people experience unexplained headaches, stomachaches, shortness of breath, nausea, etc.), more than 8 hours of sleep or rest a day, and uncomfortable positions at work.

Pregnancy and postpartum-related predictors of PGP included: increasing disability, having PGP, and higher mean pain at 6 weeks; higher somatization during pregnancy and at 6 weeks after delivery; higher birth weight of the baby; uncomfortable positions at work; and the number of days of bed rest (the higher the number of days, the less risk of PGP).

“More somatization, more hours of sleep or rest, and no days of bed rest after delivery were found to be related to an increased risk of PGP, and those are new findings,” says van Poppel. “While somatization is also a predictor of chronic low back pain and irritable bowel syndrome, it has not been previously reported as a predictor of PGP. One explanation might be that women who have PGP probably have a higher awareness of their bodily sensations. Alternatively, women who have mental problems might somatize and report PGP as a result.”

Investigators call for further research to confirm the role of sleep and somatization during pregnancy and bed rest after delivery relative to PGP.

# # #

Notes for editors
The pelvic girdle is formed by the hip bones, sacrum and coccyx.

“Predictors for postpartum pelvic girdle pain in working women: The Mom@Work cohort study,” by Suzanne G.M. Stomp-van den Berg, Ingrid J.M. Hendriksen, David J. Bruinvels, Jos W.R. Twisk, Willem van Mechelen, Mireille N.M. van Poppel (DOI: 10.1016/j.pain.2012.08.003). It appears in PAIN®, Volume 153, Issue 12 (December 2012) published by Elsevier.

Full text of the article is available to credentialed journalists upon request. Contact Christine Rullo at +1-215-239-3709 or painmedia@elsevier.com for copies. Journalists wishing to set up interviews should contact Mireille N.M. van Poppel at +31 20 444 8289/8206 or mnm.vanpoppel@vumc.nl.

About PAIN®
PAIN®, the official journal of the International Association for the Study of Pain® (IASP®), publishes 12 issues per year of original research on the nature, mechanisms, and treatment of pain. This peer-reviewed journal provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest and is cited in Current Contents and MEDLINE. It is ranked 1st out of the 28 journals in the Anesthesiology category according to the 2011 Journal Citation Reports published by Thomson Reuters. www.painjournalonline.com

About the International Association for the Study of Pain® (IASP®)
Founded in 1973, IASP® is the world's largest multidisciplinary organization focused specifically on pain research and treatment. It is the leading professional forum for science, practice, and education in the field of pain bringing together scientists, clinicians, health care providers, and policy makers to stimulate and support the study of pain and to translate that knowledge into improved pain relief worldwide. IASP currently has more than 7500 members from 130 countries and in 87 chapters. www.iasp-pain.org

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence,and ClinicalKey—and publishes over 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contact
Christine Rullo
Elsevier Health & Medical Sciences Journals
+1-215-239-3709 (office)
+1-267-210-0509 (mobile)
painmedia@elsevier.com