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. 2023 Oct;102(10):1259-1268.
doi: 10.1111/aogs.14664. Epub 2023 Aug 23.

Generalized joint hypermobility and the risk of pregnancy-related pelvic girdle pain: Is body mass index of importance?-A prospective cohort study

Kerstin Ahlqvist  1 , Elisabeth Krefting Bjelland  2   3 , Ronnie Pingel  4 , Angela Schlager  1 , Magnus Peterson  1 , Christina B Olsson  5   6 , Lena Nilsson-Wikmar  6 , Per Kristiansson  1
Affiliations

Generalized joint hypermobility and the risk of pregnancy-related pelvic girdle pain: Is body mass index of importance?-A prospective cohort study

Kerstin Ahlqvist et al. Acta Obstet Gynecol Scand. 2023 Oct.

Abstract

Introduction: Pelvic girdle pain (PGP) affects approximately 50% of pregnant women. The mechanisms are multifactorial but not fully understood. Women with generalized joint hypermobility (GJH) may be vulnerable to load in the pelvic joints during pregnancy. Our aim was to investigate if women with GJH had an increased risk of PGP and higher pain intensity during and after pregnancy, compared with women with normal joint mobility. We also studied if body mass index (BMI) in early pregnancy influenced that risk.

Material and methods: A prospective cohort study of 356 women, whose data were collected by self-reports and clinical examinations in early and in late pregnancy and 9 months after childbirth. GJH was present with ≥5/9 points on the Beighton score. PGP was defined by a pain drawing and ≥1 positive test. Pain intensity was measured with a visual analogue scale (0-100 mm). We adjusted for age and origin in logistic regression and ordinal logistic regression analysis.

Results: In early pregnancy, 47.1% of the women with GJH had PGP vs 32.6% of women with normal joint mobility (adjusted odds ratio [aOR] 1.76; 95% confidence interval [CI] 0.86-3.62) and had higher odds of reporting higher pain intensity (aOR 2.04; 95% CI 1.02-4.07). The odds of PGP were highest for women with GJH and BMI ≥25 kg/m2 (aOR 6.88; 95% CI 1.34-35.27) compared with women with normal joint mobility and BMI <25 kg/m2 . The estimated associations were weaker and not statistically significant in late pregnancy or after childbirth.

Conclusions: Women with GJH did not have an increased risk of PGP during or after pregnancy but reported higher pain intensity in early pregnancy compared with women with normal joint mobility. Since women with combined GJH and BMI ≥25 kg/m2 had the highest odds of PGP in early pregnancy, our results may suggest that health care needs to pay attention to and develop methods to reduce the risk of PGP and delay the onset of pain during pregnancy in women with this combination.

Keywords: Uppsala pelvic pain study; body mass index; generalized joint hypermobility; pelvic girdle pain; pregnancy.

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Conflict of interest statement

The authors have stated explicitly that there are no conflicts of interest in connection with this article.

Figures

FIGURE 1
FIGURE 1
A pain drawing to indicate the distribution of pain. Pelvic girdle pain was defined as pain indicated within the red borders (not shown to the women).
FIGURE 2
FIGURE 2
Flow chart of the participating pregnant women in the Uppsala Pelvic Pain Study. *Childbirth before visit 2, but participated at visit 3, n = 7; **declined visit 2, but participated at visit 3, n = 2.
See this image and copyright information in PMC

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