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. 2023 Oct;102(10):1269-1280.
doi: 10.1111/aogs.14670. Epub 2023 Sep 28.

Factors in early pregnancy predicting pregnancy-related pain in the second and third trimester

Ruth K Ertmann  1 , Dagny R Nicolaisdottir  1 , Volkert Siersma  1 , Gritt Overbeck  1 , Sarah Strøyer de Voss  1 , Frederikke Agerbo Modin  1 , Melissa C Lutterodt  1
Affiliations

Factors in early pregnancy predicting pregnancy-related pain in the second and third trimester

Ruth K Ertmann et al. Acta Obstet Gynecol Scand. 2023 Oct.

Abstract

Introduction: Pain during pregnancy affects women's well-being, causes worry and is a risk factor for the child and the mother during labor. The aim was to investigate the relative importance of an extensive set of pregnancy-related physiological symptoms and psychosocial factors assessed in the first trimester compared with the occurrence of pregnancy-related pain symptoms later in the pregnancy.

Material and methods: Included were all women who booked an appointment for a first prenatal visit in one of 125 randomly selected general practitioner practices in Eastern Denmark from April 2015 to August 2016. These women answered an electronic questionnaire containing questions on the occurrence of five pregnancy-related pain symptoms: back pain, leg cramps, pelvic cavity pain, pelvic girdle pain and uterine contractions. The questionnaire also included sociodemographic questions and questions on chronic diseases, physical symptoms, mental health symptoms, lifestyle and reproductive background. The questionnaire was repeated in each trimester. The relative importance of this set of factors from the first trimester on the five pregnancy-related pain symptoms compared with the second and third trimesters was assessed in a dominance analysis.

Results: A total of 1491 women were included. The most important factor for pregnancy-related pain in the second trimester and third trimester is the presence of the corresponding pain in the first trimester. Parity was associated with pelvic cavity pain and uterine contractions in the following pregnancies. For back pain and pelvic cavity pain, the odds increased as the women's estimated low self-assessed fitness decreased and had low WHO-5 wellbeing scores.

Conclusions: When including physical risk factors, sociodemographic factors, psychological factors and clinical risk factors, women's experiences of pregnancy-related pain in the first trimester are the most important predictors for pain later in pregnancy. Beyond the expected positive effects of pregnancy-related pain, notably self-assessed fitness, age and parity were predictive for pain later in pregnancy.

Keywords: early complications; epidemiology; pain; patient-reported measures; 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
Flowchart of inclusion.
FIGURE 2
FIGURE 2
Relative importance of factors in the second trimester. The relative importance (%) of pregnancy‐related factors is distributed among the five pain outcomes; back pain, leg cramps, pelvic cavity pain, pelvic girdle pain and uterine contractions. Larger bars indicate greater importance. The top five important factors are indicated in the right margin of each panel.
FIGURE 3
FIGURE 3
Relative importance of factors in the third trimester. The relative importance (%) of pregnancy‐related factors is distributed among the five pain outcomes; back pain, leg cramps, pelvic cavity pain, pelvic girdle pain and uterine contractions. Larger bars indicate greater importance. The top five important factors are indicated in the right margin of each panel.
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References

    1. Lutterodt MC, Kahler P, Kragstrup J, Nicolaisdottir DR, Siersma V, Ertmann RK. Examining to what extent pregnancy‐related physical symptoms worry women in the first trimester of pregnancy: a cross‐sectional study in general practice. BJGP Open. 2019;3(4):bjgpopen19X101674. doi:10.3399/bjgpopen19X101674 - DOI - PMC - PubMed
    1. Persson M, Winkvist A, Dahlgren L, Mogren I. "Struggling with daily life and enduring pain": a qualitative study of the experiences of pregnant women living with pelvic girdle pain. BMC Pregnancy Childbirth. 2013;13:111. - PMC - PubMed
    1. Saraswat L, Bhattacharya S, Maheshwari A, Bhattacharya S. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG. 2010;117:245‐257. - PubMed
    1. Gutke A, Olsson CB, Völlestad N, Öberg B, Wikmar LN, Robinson HS. Association between lumbopelvic pain, disability and sick leave during pregnancy—a comparison of three Scandinavian cohorts. J Rehabil Med. 2014;46:468‐474. - PubMed
    1. Malmqvist S, Kjaermann I, Andersen K, Økland I, Larsen JP, Brønnick K. The association between pelvic girdle pain and sick leave during pregnancy; a retrospective study of a Norwegian population. BMC Pregnancy Childbirth. 2015;15:237. - PMC - PubMed