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

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 wome...

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Main Authors: Kerstin Ahlqvist, Elisabeth Krefting Bjelland, Ronnie Pingel, Angela Schlager, Magnus Peterson, Christina B. Olsson, Lena Nilsson‐Wikmar, Per Kristiansson
Format: Article
Language:English
Published: Wiley 2023-10-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.14664
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author Kerstin Ahlqvist
Elisabeth Krefting Bjelland
Ronnie Pingel
Angela Schlager
Magnus Peterson
Christina B. Olsson
Lena Nilsson‐Wikmar
Per Kristiansson
author_facet Kerstin Ahlqvist
Elisabeth Krefting Bjelland
Ronnie Pingel
Angela Schlager
Magnus Peterson
Christina B. Olsson
Lena Nilsson‐Wikmar
Per Kristiansson
author_sort Kerstin Ahlqvist
collection DOAJ
description 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.
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spelling doaj-art-81ef7232b32d407b94608f0e56d28ce12025-08-20T02:09:28ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-10-01102101259126810.1111/aogs.14664Generalized joint hypermobility and the risk of pregnancy‐related pelvic girdle pain: Is body mass index of importance?—A prospective cohort studyKerstin Ahlqvist0Elisabeth Krefting Bjelland1Ronnie Pingel2Angela Schlager3Magnus Peterson4Christina B. Olsson5Lena Nilsson‐Wikmar6Per Kristiansson7Department of Public Health and Caring Sciences Uppsala University Uppsala SwedenDepartment of Rehabilitation Science and Health Technology Oslo Metropolitan University Oslo NorwayDepartment of Statistics Uppsala University Uppsala SwedenDepartment of Public Health and Caring Sciences Uppsala University Uppsala SwedenDepartment of Public Health and Caring Sciences Uppsala University Uppsala SwedenAcademic Primary Healthcare Center Stockholm County Council Huddinge SwedenDepartment of Neurobiology, Care Sciences and Society, Division of Physiotherapy Karolinska Institutet Huddinge SwedenDepartment of Public Health and Caring Sciences Uppsala University Uppsala SwedenAbstract 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.https://doi.org/10.1111/aogs.14664body mass indexgeneralized joint hypermobilitypelvic girdle painpregnancyUppsala pelvic pain study
spellingShingle Kerstin Ahlqvist
Elisabeth Krefting Bjelland
Ronnie Pingel
Angela Schlager
Magnus Peterson
Christina B. Olsson
Lena Nilsson‐Wikmar
Per Kristiansson
Generalized joint hypermobility and the risk of pregnancy‐related pelvic girdle pain: Is body mass index of importance?—A prospective cohort study
Acta Obstetricia et Gynecologica Scandinavica
body mass index
generalized joint hypermobility
pelvic girdle pain
pregnancy
Uppsala pelvic pain study
title Generalized joint hypermobility and the risk of pregnancy‐related pelvic girdle pain: Is body mass index of importance?—A prospective cohort study
title_full Generalized joint hypermobility and the risk of pregnancy‐related pelvic girdle pain: Is body mass index of importance?—A prospective cohort study
title_fullStr Generalized joint hypermobility and the risk of pregnancy‐related pelvic girdle pain: Is body mass index of importance?—A prospective cohort study
title_full_unstemmed Generalized joint hypermobility and the risk of pregnancy‐related pelvic girdle pain: Is body mass index of importance?—A prospective cohort study
title_short Generalized joint hypermobility and the risk of pregnancy‐related pelvic girdle pain: Is body mass index of importance?—A prospective cohort study
title_sort generalized joint hypermobility and the risk of pregnancy related pelvic girdle pain is body mass index of importance a prospective cohort study
topic body mass index
generalized joint hypermobility
pelvic girdle pain
pregnancy
Uppsala pelvic pain study
url https://doi.org/10.1111/aogs.14664
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