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Clinical Obstetrics

Poster Session 1

(196) Association between Trunk Muscle Mass and Persistent Postpartum Low Back and Pelvic Pain

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Low back and pelvic pain (LBPP) is commonly experienced during pregnancy and the postpartum period, accounting for 15% of chronic lumbar pain in women unrelated to pregnancy. Although the association of LBPP with reduced trunk muscle mass (TMM) are considered out of pregnancy, few studies have examined this association in relation to pregnancy and the postpartum period, especially regarding persistent postpartum LBPP. The aim of the study was to investigate whether early postpartum TMM was associated with LBPP four months after delivery.

Study Design: This prospective observational study recruited singleton pregnant women with LBPP at 35 weeks’ gestation and measured their TMM using a body composition analyzer (Tanita MC780A-N) four weeks after delivery. Women who still experienced LBPP at four months postpartum were defined as having persistent postpartum (pp)-LBPP. Risk factors associated with pp-LBPP were identified among baseline and perinatal characteristics, including age, parity, body mass index, pre-pregnancy history of LBPP and physical activity, delivery methods, and breastfeeding. We investigated whether TMM was associated with pp-LBPP after adjusting these risk factors.

Results: Among 209 women with LBPP during pregnancy, 101 women (48%) had pp-LBPP. In a multivariate analysis, age (adjusted odds ratio 1.10/year [95% confidence interval 1.03-1.17/year]), primipara (2.40 [1.21-4.75]), cesarean section (3.39 [1.51-7.64]), and the lack of pre-pregnancy athletic activity (2.04 [1.01-4.12]) were identified as independent risk factors associated with pp-LBPP. TMM was significantly higher in women with pp-LBPP than in women without pp-LBPP (19.5±1.2 vs 19.1±1.1 kg, p< .001), and

was not found to be associated with pp-LBPP in the multivariate model.

Conclusion: In this prospective study, women with traditional risk factors, including older age, primiparity, lack of pre-pregnancy athletic activity, and cesarean section appear to be at high risk for developing pp-LBPP. However, no association was found between early postpartum TMM and pp-LBPP.