Role of depressive symptoms on the development of pelvic girdle pain in pregnancy: A prospective inception cohort study
Abstract Introduction Pelvic girdle pain in pregnancy is a major public health concern. For too many women, the pain condition causes disability and sick leave, has a negative impact on daily life, and breeds doubt in their view as mother, partner, and worker. The pathophysiology is unknown and caus...
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| Format: | Article |
| Language: | English |
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Wiley
2023-10-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14562 |
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| author | Teresa Algård Paul Kalliokoski Kerstin Ahlqvist Angela Schlager Per Kristiansson |
| author_facet | Teresa Algård Paul Kalliokoski Kerstin Ahlqvist Angela Schlager Per Kristiansson |
| author_sort | Teresa Algård |
| collection | DOAJ |
| description | Abstract Introduction Pelvic girdle pain in pregnancy is a major public health concern. For too many women, the pain condition causes disability and sick leave, has a negative impact on daily life, and breeds doubt in their view as mother, partner, and worker. The pathophysiology is unknown and causal treatment is lacking. Depression in pregnancy is common, undertreated, and previously associated with pelvic girdle pain with unclear causal direction. Material and methods A prospective inception cohort study of 356 Swedish women examined them in early and late pregnancy. Women with a positive Posterior Pelvic Pain Provocation test in early pregnancy were not included. The exposure, depressive symptoms in early pregnancy, was self‐reported on the Hospital Anxiety and Depression Scale, depression part (0–21). Outcome measure in late pregnancy was a graded score on the Posterior Pelvic Pain Provocation test (0–8). Covariates for statistical adjustment were identified in a directed acyclic graph. Linear robust and logistic regression were used in the statistical analyses. Results In early pregnancy, the 248 women with negative Posterior Pelvic Pain Provocation test had a mean score of 2.35 (± 2.3 standard deviation) on the Hospital Anxiety and Depression Scale, depression part. In a fully adjusted, multiple robust regression model a positive association was shown between Hospital Anxiety and Depression Scale score, depression part, and the Posterior Pelvic Pain Provocation test score in late pregnancy with an estimated effect of β = 0.32 (95% confidence interval [CI] 0.16–0.48, p < 0.001). Dichotomization of exposure (Hospital Anxiety and Depression Scale, depression part <8/≥8) and outcome (Posterior Pelvic Pain Provocation test score 0/>0) rendered adjusted odds ratio 1.71 (95% CI 0.38–7.7) and numbers needed to treat adjusted odds ratio 5.54 (95% CI −3.4–14.5). Conclusions Depressive symptoms in early pregnancy were associated with the development and intensity of pelvic girdle pain in late pregnancy. Considering the small sample size, screening and treatment for depressive symptoms in early pregnancy may enable a way to reduce and prevent disabling pelvic girdle pain in late pregnancy. Trials are needed to confirm the results. |
| format | Article |
| id | doaj-art-daf6e470ee4c4bc4ad1f4c74e9de40d3 |
| institution | Kabale University |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-daf6e470ee4c4bc4ad1f4c74e9de40d32025-08-20T03:31:01ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-10-01102101281128910.1111/aogs.14562Role of depressive symptoms on the development of pelvic girdle pain in pregnancy: A prospective inception cohort studyTeresa Algård0Paul Kalliokoski1Kerstin Ahlqvist2Angela Schlager3Per Kristiansson4Department of Public Health and Caring Sciences Uppsala University Uppsala SwedenDepartment of Public Health and Caring Sciences Uppsala University Uppsala SwedenDepartment of Public Health and Caring Sciences Uppsala University Uppsala SwedenDepartment of Public Health and Caring Sciences Uppsala University Uppsala SwedenDepartment of Public Health and Caring Sciences Uppsala University Uppsala SwedenAbstract Introduction Pelvic girdle pain in pregnancy is a major public health concern. For too many women, the pain condition causes disability and sick leave, has a negative impact on daily life, and breeds doubt in their view as mother, partner, and worker. The pathophysiology is unknown and causal treatment is lacking. Depression in pregnancy is common, undertreated, and previously associated with pelvic girdle pain with unclear causal direction. Material and methods A prospective inception cohort study of 356 Swedish women examined them in early and late pregnancy. Women with a positive Posterior Pelvic Pain Provocation test in early pregnancy were not included. The exposure, depressive symptoms in early pregnancy, was self‐reported on the Hospital Anxiety and Depression Scale, depression part (0–21). Outcome measure in late pregnancy was a graded score on the Posterior Pelvic Pain Provocation test (0–8). Covariates for statistical adjustment were identified in a directed acyclic graph. Linear robust and logistic regression were used in the statistical analyses. Results In early pregnancy, the 248 women with negative Posterior Pelvic Pain Provocation test had a mean score of 2.35 (± 2.3 standard deviation) on the Hospital Anxiety and Depression Scale, depression part. In a fully adjusted, multiple robust regression model a positive association was shown between Hospital Anxiety and Depression Scale score, depression part, and the Posterior Pelvic Pain Provocation test score in late pregnancy with an estimated effect of β = 0.32 (95% confidence interval [CI] 0.16–0.48, p < 0.001). Dichotomization of exposure (Hospital Anxiety and Depression Scale, depression part <8/≥8) and outcome (Posterior Pelvic Pain Provocation test score 0/>0) rendered adjusted odds ratio 1.71 (95% CI 0.38–7.7) and numbers needed to treat adjusted odds ratio 5.54 (95% CI −3.4–14.5). Conclusions Depressive symptoms in early pregnancy were associated with the development and intensity of pelvic girdle pain in late pregnancy. Considering the small sample size, screening and treatment for depressive symptoms in early pregnancy may enable a way to reduce and prevent disabling pelvic girdle pain in late pregnancy. Trials are needed to confirm the results.https://doi.org/10.1111/aogs.14562depressive symptomspelvic girdle painpelvic painpregnancy |
| spellingShingle | Teresa Algård Paul Kalliokoski Kerstin Ahlqvist Angela Schlager Per Kristiansson Role of depressive symptoms on the development of pelvic girdle pain in pregnancy: A prospective inception cohort study Acta Obstetricia et Gynecologica Scandinavica depressive symptoms pelvic girdle pain pelvic pain pregnancy |
| title | Role of depressive symptoms on the development of pelvic girdle pain in pregnancy: A prospective inception cohort study |
| title_full | Role of depressive symptoms on the development of pelvic girdle pain in pregnancy: A prospective inception cohort study |
| title_fullStr | Role of depressive symptoms on the development of pelvic girdle pain in pregnancy: A prospective inception cohort study |
| title_full_unstemmed | Role of depressive symptoms on the development of pelvic girdle pain in pregnancy: A prospective inception cohort study |
| title_short | Role of depressive symptoms on the development of pelvic girdle pain in pregnancy: A prospective inception cohort study |
| title_sort | role of depressive symptoms on the development of pelvic girdle pain in pregnancy a prospective inception cohort study |
| topic | depressive symptoms pelvic girdle pain pelvic pain pregnancy |
| url | https://doi.org/10.1111/aogs.14562 |
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