Psychological determinants of pregnancy-related lumbopelvic pain: a prospective cohort study.

OBJECTIVE To study whether pregnancy-related lumbopelvic pain outcomes at 36 weeks of gestation can be predicted by psychological determinants earlier in pregnancy. DESIGN Prospective cohort study. SETTING Nine midwifery practices in different regions of the Netherlands. POPULATION A cohort of 223 low-risk pregnant women in the Netherlands was followed from week 12 of gestation until 36 weeks of gestation. METHODS Both psychological determinants and lumbopelvic pain symptoms were investigated with a set of questionnaires at 12, 24 and 36 weeks of gestation. Psychological determinants were measured with the Perceived Stress Scale (PSS), the Symptom Checklist-90-Revised (SCL-90), the Pregnancy-related Anxiety Questionnaire (PRAQ), and the Utrecht Coping List (UCL). Lumbopelvic pain outcomes were measured with the Pregnancy Mobility Index (PMI) and the Overall Complaints Index (OCI). MAIN OUTCOME MEASURES Lumbopelvic pain symptoms and their impact at 36 weeks of gestation. RESULTS There was a significant increase in scores on both the PMI and OCI across the three sampling occasions in pregnancy. Lumbopelvic pain outcomes showed significant associations with the psychological determinants perceived stress and recently perceived psychological and physical distress at all three times during pregnancy. Pregnancy-related anxiety was not a significant predictor of lumbopelvic pain outcomes, neither was coping. CONCLUSIONS Lumbopelvic pain symptoms and their impact on daily activities at 36 weeks of gestation can be predicted by psychological determinants earlier in pregnancy; the combination of perceived stress and physical disability at 24 weeks of pregnancy seems to be the best predictor of disability in later pregnancy.