Lumbopelvic pain, anxiety, physical activity and mode of conception: a prospective cohort study of pregnant women

Abstract

ObjectivesPregnancy-related lumbopelvic pain (LPP) is a frequent condition known to significantly affect women in their daily life. The aetiology of pregnancy-related LPP pain is still not clearly established but the mode of conception has been suggested to contribute to LPP. Anxiety related to fertility treatments may be one of the contributing factors. The primary objectives of this study were to determine the evolution of LPP prevalence and severity, and anxiety throughout pregnancy in women who conceived spontaneously (SP) or after fertility treatments (FT). A further aim was to examine the relationship between pregnancy-related LPP severity and anxiety. The secondary objective was to determine the evolution of physical activity and their correlation with the severity of pregnancy-related LPP.DesignProspective cohort study.SettingPregnant women were recruited through physicians’ referrals, posters and newspaper advertisements in the local and surrounding communities (hospital, maternity care clinic, prenatal centres, sports centres, local university) in the city of Trois-Rivières, Canada.Participants59 pregnant women (33 SP and 26 FT) were assessed during the first, second and third trimester of pregnancy.Primary and secondary outcome measuresPregnancy-related LPP prevalence and severity (primary), trait and state anxiety, and physical activity levels (secondary).ResultsThere was no relationship between the mode of conception and the outcome measures. The prevalence and severity of LPP increased over the course of pregnancy (time effect, p<0.0001) whereas trait anxiety decreased from early to mid-pregnancy (time effect, p=0.03). Activity limitations increased throughout pregnancy (time effect, p<0.0001) and physical activity levels decreased (time effect, p<0.0001). The severity of LPP was positively correlated with activity limitations (r=0.51 to 0.55) but negatively with physical activity levels (r=−0.39 to −0.41).ConclusionsMaternal health-related factors, such as LPP, anxiety and physical activity, are not different in women who conceived spontaneously or after fertility treatments. The more LPP was severe, the more the women were physically limited and inactive.

The Nutritional Behaviour of Pregnant Women in Poland

“…In addition, despite the health benefits of regular physical activity during pregnancy, many women do not follow the recommended guidelines. Many studies indicate a decrease in the level of physical activity of pregnant women, this phenomenon was also observed in our study [57,58,59]. In our study, the vast majority of women (59.83%) described their physical activity as low, 36.94% as moderate, and 3.22% as high.…”

Reproductive history, maternal anxiety and past physical activity practice predict physical activity levels throughout pregnancy

“…This hypothesis was based on the fact that the former would experience more anxiety, especially fear to lose their baby, than the latter (Gourounti, 2016) and that greater anxiety would thereby result in lower PA practice among women who conceived after FT. However, our previous data revealed that anxiety levels were not different between women who conceived after FT and those who conceived naturally (Lardon et al, 2018), which could explain, at least in part, our result showing similar PA level in women, independently of their mode of conception. Nevertheless, our results are consistent with those of a prospective cohort study showing no difference in prenatal PA levels between women who conceived naturally (n = 295) and those who conceived after IVF (n = 297) (Fisher et al, 2013).…”

“…Our result is still consistent with those reported in previous prospective and retrospective studies using subjective or objective measures of prenatal PA (Hayes et al, 2015, Hegaard et al, 2011, Owe et al, 2009). The decrease in PA levels over the course of pregnancy can be explained by different factors, such as the increase in physical discomforts and pelvic girdle pain as pregnancy progresses (Lardon et al, 2018, Owe et al, 2009). We were also expecting to find a greater decline in PA levels over the course of pregnancy in women who conceived after FT compared to those who conceived naturally.…”

“…A daily diary was given to each woman to document wear and non-wear periods as well as participation to structured activities. For more details about PA data analysis, see Lardon et al (2018). To define sedentary time and each intensity of PA, we used Freedson cut-points (sedentary: <100 cut-points per minute [CPM], light: 100–1951 CPM, moderate: 1952–5724 CPM and vigorous: >5725 CPM) (Freedson et al, 1998).…”

Effectiveness of Physical Activity Interventions on Pregnancy-Related Outcomes among Pregnant Women: A Systematic Review

“…Previous studies have also explored the factors that hamper the maintenance of a sufficient physical activity level among pregnant women. Indeed, pregnant women were reported to often experience a repertoire of pregnancy-related symptoms, including lumbopelvic pain [13], psychological issues, such as anxiety and depression [14], and gestational weight gain [15], some of which would likely present a barrier for pregnant women to exhibit a higher level of physical activity [16,17]. Some pregnant women also indicated that a lack of time available for physical exercises, due to their busy work schedule, was also a contributing factor in their lack of physical activity [18].…”