Low back pain intensity among childbearing women and associated predictors. A cohort study

Global, regional, and national burdens of low back pain in women of childbearing age from 1990 to 2021: an analysis based on the global burden of disease study 2021

BACKGROUND

Low back pain (LBP) is very common in women of child bearing age (WCBA) and is a major burden on individuals and society, but studies about it have not been reported.

METHODS

Trend analyses were based on data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2021. We investigated global trends in the number of prevalence cases, prevalence and the years lived with disability (YLDs), and the YLDs rate for LBP in the WCBA. We used joint point regression analyses to report average annual changes and identify the most variable years in the global trend. Simultaneously, we further analyzed these trends by stratifying them by the region, nation, and age.

RESULTS

Globally, the number of the prevalence and the YLDs for LBP increased substantially from 1990 to 2021(the prevalence: 39.65%) (the YLDs: 39.53%), whereas the prevalence and the YLDs rate of WCBA LBP decreased (the prevalence: AAPC: -0.1355 [95% CI -0.1419 to -0.1288) (the YLDs: AAPC: -0.1365 [95% CI -0.1427 to -0.1302]). Regionally, the prevalence and the YLDs rate of LBP among WCBA in the medium socio-demographic index region showed an increasing trend(the prevalence: AAPC: 0.1291 [95% CI: 0.118 to 0.1396]) (the YLDs: AAPC: 0.1371 [95% CI: 0.1251 to 0.1499]). Nationally, Thailand and Vietnam were the countries with the largest increases in YLD rates(Thailand: AAPC: 0.7742 [95% CI: 0.7589 to 0.7904]) (Vietnam: AAPC: 0.7364 [95% CI: 0.7263 to 0.7468]). In age patterns, the highest prevalence and YLDs rates of LBP were found among women in the 45-49 age group(the prevalence: 14,412.77 per 100,000 in 2021 [95% UI: 10,482.27 to 19,077.3]) (the YLDs: 1,639.56 per 100,000 population (95% UI: 1,035.24 to 2,494.9]).

CONCLUSION

Despite declines in the prevalence and YLDs of WCBA LBP, the burden remains high. Age- and region-specific prevention and healthcare strategies should be optimized to meet the needs of WCBA and reduce the burden of disease.

Low back pain in a sample of Syrian pregnant women: A cross-sectional study

Introduction

Low back pain related to pregnancy occurs in 60%-70% of pregnancies, at any time during pregnancy. During pregnancy, many factors such as weight gain, and others are the causes of the back pain. In Syria, due to the circumstances of the war, many pregnant women may be exposed to increase the risk of lower back pain, so this study will determine the prevalence of lower back pain among pregnant women and its potential risk factors. We aimed to evaluate the prevalence of low back pain in pregnant women and to assess the risk factors related to it.

Methods

A cross-sectional, observational study was conducted between May 2020 and December 2022 at Obstetrics and Gynecology University Hospital in Damascus, Syria. Pregnant women aged over 18 years were selected from the outpatient clinic. Participants, after signing the informed consent, fill out the survey, which included the following parameters: age, weight, height, body mass index (BMI), education, parity, shoe type, weekly walking hours, occupation, low back pain, in which semester, radiation, onset, alleviating and aggravating factors, disability, and pain in previous pregnancies. We used Excel 2010, and the Statistical Package for the Social Sciences version 23.0. p < 0.05 was considered statistically significant, and we used the Chi-square test (χ 2 test), t student test to test the basal differences between groups.

Results

A number of 551 pregnant participants were included and low back pain prevalence was 62%. There was a statistically significant relation between low back pain and each of the following: Obesity, weekly walking hours, pain in previous pregnancies, and occupation.

Conclusion

Low back pain is prevalent during pregnancy and the most important risk factors include obesity and pain in previous pregnancies whereas walking and employment are protective measures to prevent low back pain.

Long-Acting Bupivacaine for Pain Control After Cesarean Birth

OBJECTIVE

To evaluate women's postcesarean pain levels and total opioid use for standard opioid pain management compared with local anesthetic with patient-requested opioids.

DESIGN

Retrospective cohort study.

SETTING/LOCAL PROBLEM

Rural southeast Ohio. Ohio had a higher rate of opioid use disorder (1.4%) than both the regional average (0.8%) and the national average (0.7%).

PARTICIPANTS

We performed a retrospective study of 402 medical records of women who gave birth by caesarean.

INTERVENTION

Women were provided one of three types of perioperative anesthesia: routine spinal (standard of care group), wound infiltration with liposomal bupivacaine (LB INF), and transversus abdominis plane (TAP) block with liposomal bupivacaine (LB TAP).Data were collected on the amount of opioids taken postoperatively (measured as morphine milligram equivalents [MME]), pain scores, and history of opioid use.

RESULTS

The LB INF and LB TAP groups had significantly lower total and average MME per day than the standard of care group (p < .001). Pain scores for the LB INF group were lower on postoperative day (POD) 0 and POD1, whereas LB TAP pain scores were lower than standard of care pain scores on POD1 (p < .004). Women with a prior history of substance use disorders reported higher pain scores, took more total opioids. and stayed in the hospital longer regardless of type of anesthesia received (p < .001).

CONCLUSION

LB INF and LB TAP were associated with lower amounts of opioids used and with lower postcesarean pain scores compared with the standard of care.

Changes of health related quality of life during pregnancy based on pregnancy context: a prospective study

Background

The significance of planned pregnancy is an accepted principle for improving the health of pregnant women; and quality of life, as one of the important indicators of women’s health, is reduced in high-risk pregnancies. The aim of this research was to investigate the changes in the health related quality of life (HRQL) in low risk pregnancies in different groups based on pregnancy context.

Methods

The present study was a prospective study conducted on 250 pregnant women divided into three groups of women with planned pregnancy, unplanned/wanted pregnancy and unwanted pregnancy. Then, using WHOQOL-26 questionnaire, the quality of life of these women was measured in physical, psychological, social and environmental dimensions at the beginning of pregnancy as well as at the end of the first, second and third trimesters.

Results

Based on the results, the mean score of environmental-HRQL in women with unwanted pregnancy was significantly lower than the other two groups. All dimensions on HRQL were influenced by time and group. However, changes in the physical, psychological and social dimensions of HRQL varied within the groups. Physical- HRQL changes were different within the groups. The intergroup effect on environmental dimension of quality of life changes was significant.

Conclusions

It was observed in this study that HRQL in the women with unwanted pregnancy was lower than the women with planned pregnancy and those with unplanned /wanted pregnancy. Moreover, increase in gestational age would lower quality of life, but this decline had a similar pattern in different groups.

Sporadic cauda equina hemangioblastoma: surgical management in a pregnant woman

Hemangioblastoma is a rare benign vascular tumour of the central nervous system that occurs either sporadically or in association with Von Hippel-Lindau syndrome. Hemangioblastoma can be found throughout the central nervous system and usually present with late manifestations due to their slow growth rate. Cauda equina hemangioblastomas are extremely rare, and in the literature, no cases are reported on the surgical management of pregnant patients with this condition. We report the case of a young woman with back pain and sphincter dysfunctions in whom an L1-L2 hemangioblastoma was diagnosed. We describe the perioperative and surgical strategies we adopted to successfully treat the patient and preserve the fetus well-being.

Body perception disturbances in women with pregnancy-related lumbopelvic pain and their role in the persistence of pain postpartum

Background

Lumbopelvic pain (LPP) is common during pregnancy and can have long-lasting negative consequences in terms of disability and reduced quality of life. Therefore, it is crucial to identify women at risk of having pregnancy-related LPP after childbirth. This study aimed to investigate the association between body perception, pain intensity, and disability in women with pregnancy-related LPP during late pregnancy and postpartum, and to study whether a disturbed body perception during late pregnancy predicted having postpartum LPP.

Methods

A prospective cohort study in 130 primiparous women (median age = 30 years) was performed. Pain intensity, disability, and lumbopelvic body perception during the last month of pregnancy and 6 weeks postpartum were assessed with the Numerical Pain Rating Scale (NPRS), Oswestry Disability Index, and Fremantle Back Awareness Questionnaire, respectively. Having pregnancy-related LPP was defined as an NPRS score ≥ 1/10. At both timepoints, women were categorized into three groups; pain-free, LPP with low disability, and LPP with high disability (based on Oswestry Disability Index scores). At each timepoint, body perception was compared between groups, and correlations between body perception, pain intensity, and disability were evaluated in women with LPP by using non-parametric tests. Logistic regression analysis was used to determine whether body perception during the last month of pregnancy predicted the presence of LPP 6 weeks postpartum.

Results

Women with LPP at the end of pregnancy, and 6 weeks postpartum reported a more disturbed body perception compared to pain-free women (p ≤ 0.005). Greater body perception disturbance correlated with higher pain intensity (σ = 0.266, p = 0.008) and disability (σ = 0.472, p < 0.001) during late pregnancy, and with pain intensity 6 weeks postpartum (σ = 0.403, p = 0.015). A disturbed body perception during late pregnancy nearly significantly predicted having postpartum LPP (Odds Ratio = 1.231, p = 0.052).

Conclusions

Body perception disturbance was greater in women experiencing LPP during late pregnancy and postpartum compared to pain-free women, and correlated with pain intensity and disability. Though non-significant (p = 0.052), the results of the regression analysis suggest that greater body perception disturbance during late pregnancy might predict having LPP postpartum. However, future studies should follow up on this.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-021-03704-w.

Prevalence and influencing factors of low back pain among nurses in China: a systematic review and meta-analysis

Background

Low back pain (LBP) is one of the most common occupational injuries that nurses experience in their daily work, which ultimately causes disability or difficulty in performing heavy physical activity. There is scarce information that presents a direct figure about the prevalence of LBP in Chinese nurses.

Objective

To systematically review and analyze the prevalence and influencing factors of LBP among nurses in China.

Methods

Related literature extracted from PubMed, Web of Science, Scopus, China National Knowledge Infrastructure databases were selected and reviewed based on the PRISMA guideline. Random effects models were used for data analysis, where heterogeneity was tested through I2. Egger's test was used to analyze the literature publication bias.

Results

The combined data indicated that the prevalence of LBP among nurses in China was 78% [95% confidence interval (CI) = 0.72–0.83]. The prevalence of LBP among nurses in China has declined in the past decade. Nurses presented a high risk of LBP in terms of female (OR = 2.38, 95% CI = 1.23–3.44, P < 0.0001), married (OR = 2.79, 95% CI = 1.57–3.86, P < 0.0001), 24 ≤ BMI < 28 (OR = 2.03, 95% CI = 1.18–3.08, P < 0.0001), and working for more than ten >10 years (OR = 2.54, 95% CI = 2.03–3.32, P < 0.0001).

Conclusions

There is a high prevalence of LBP among nurses in China. Interventions that include healthy dietary habits and physical activity mainly focusing on female married nurses who are working for at least 10 years should be implemented. Furthermore, nurses ought to apply ergonomic principles for personal protection at the workplace.

Correlation between baropodometric variables, disability, and intensity of low back pain in pregnant women in the third trimester

BACKGROUND

Growth of uterus, enlargement of breasts and weight gain result from the development and growth of the fetus during pregnancy. The posture and the displacement of the center of gravity change.

OBJECTIVE

Correlate baropodometric variables with low back pain in pregnant women in the third trimester of pregnancy.

METHODS

This is a cross-sectional analytical study conducted in São Luís (MA, Brazil). For data collection, we used a form containing sociodemographic and clinical data, Oswestry Disability Questionnaire for disability evaluation of the lumbar spine, Numerical Rating Scale to measure pain intensity, and baropodometric evaluation.

RESULTS

Twenty-five pregnant women took part in the study. There was a significant and positive correlation (r = 0.404, p = 0.045) between functional disability and hindfoot pressure and a significant and negative correlation (r = -0.404, p = 0.045) between functional disability and plantar pressure in the forefoot of the right foot. In addition, there was a positive and significant correlation between the intensity of pain and the contact area on the left (r = 0.504, p = 0.010) and right (r = 0.509, p = 0.009) foot.

CONCLUSION

There is a relation between disability and plantar pressure and between pain intensity and area of contact of feet in pregnant women.

Associations between the number of children, age at childbirths and prevalence of chronic low back pain: the Nord-Trøndelag Health Study

Background

Associations between childbirths and subsequent risk of low back pain (LBP) have not been clarified. Changes in sex hormone levels or lumbar posture during pregnancy may have an impact on LBP later in life. The purpose of this study was to explore associations between the number of childbirths, age at childbirths and prevalence of chronic LBP in a general population of women.

Methods

Data were obtained from the Norwegian community-based Nord-Trøndelag Health Study, HUNT2 (1995–1997). Women aged 20–69 years indicated whether they suffered from chronic LBP, defined as LBP persisting at least 3 months continuously during last year. Information about LBP was collected from 3936 women who had experienced no childbirths, 3143 women who had delivered one child only and 20,584 women who had delivered 2 or more children. Of these, 7339 women reported chronic LBP. The 595 women who were pregnant when information was collected were considered separately, regardless of previous births, with 80 women reporting chronic LBP. Associations with prevalence of chronic LBP were examined by generalised linear modelling with adjustment for potential confounders in a cross-sectional design.

Results

Women who had delivered one child only showed a higher prevalence of chronic LBP than women with no childbirths (prevalence ratio (PR) 1.11; 95% CI: 1.01–1.22). Among women with one or more childbirths, no overall change in prevalence could be demonstrated with an increasing number of children in analyses adjusted for age at first delivery. In women with at least two childbirths, an age less than 20 years at first childbirth was associated with an increased prevalence of chronic LBP (PR 1.36; 95% CI: 1.25–1.49; compared with age 25–29 years). No association was observed between age at last delivery and chronic LBP. The lowest prevalence of chronic LBP was found among women who were currently pregnant (PR 0.80; 95% CI: 0.63–1.00; compared with women with no childbirths).

Conclusions

Having experienced at least one childbirth seems to be associated with a higher prevalence of chronic LBP later in life. A young age at first childbirth is also associated with a long-lasting increased prevalence.