{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T23:39:44Z","timestamp":1781048384548,"version":"3.54.1"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Geburtshilfe Neonatol"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\nAim To evaluate low back pain (LBP) incidence and impact throughout pregnancy in terms of women\u2019s well-being and delivery outcomes.<\/jats:p><jats:p>\nMaterial and methods Cross-sectional prospective study conducted on singleton pregnancies at \u226537th gestational age admitted for delivery. Localization of LBP, intensity and frequency as well as derived functional disability status were assessed with a self-reported questionnaire. Main delivery outcomes including mode of delivery, and maternal or neonatal complications were recorded.<\/jats:p><jats:p>\nResults A total of 229 women participated in the study. LBP prevalence amounted to 55.9%, with the pain already present before pregnancy in 14.0% of the cases. The pain was mostly localized in the lower back (40.6%), symphysis (23.3%), and coccyx (20.5%). Both the frequency and intensity of pain gradually increased significantly during pregnancy, reaching 20 days\/month (IQR=10\u201330) and 6\/10 points (IQR=5\u20138) on a visual analog scale in the 3rd trimester (p&lt;0.05). The extent of functional impairment also progressively increased up to 39\/100 points (IQR=25\u201355, p&lt;0.05). Women affected by LBP during pregnancy had a higher cesarean section rate during labor than women without LBP (11.9% vs. 28.9%, p&lt;0.05). The risk was also significant in the multivariate analysis (OR=4.0, 95%CI=1.1\u201315.0, p&lt;0.05). There was no difference in the rate of operative vaginal births or in the other outcomes considered.<\/jats:p><jats:p>\nConclusions LBP is a common issue in pregnant women, accounting for increasing morbidity and invalidity, and leading to an increased cesarean section risk during labor.<\/jats:p>","DOI":"10.1055\/a-1553-4856","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T22:55:06Z","timestamp":1629932106000},"page":"104-111","source":"Crossref","is-referenced-by-count":10,"title":["Low Back Pain during Pregnancy and Delivery Outcomes"],"prefix":"10.1055","volume":"226","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8958-6049","authenticated-orcid":false,"given":"Arrigo","family":"Fruscalzo","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, St. Franziskus-Hospital Ahlen, Ahlen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Cocco","sequence":"additional","affiliation":[{"name":"Pediatric Surgery, University of Naples Federico II School of Medicine and Surgery, Napoli, Italy and Pediatric Surgery, San Bortolo Hospital, Vicenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambrogio P.","family":"Londero","sequence":"additional","affiliation":[{"name":"Clinic of Gynecology and Obstetrics, University Hospital of Udine, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Gantert","sequence":"additional","affiliation":[{"name":"Gynecology and Obstetrics, St. Franziskus-Hospital Ahlen, Ahlen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1136\/bmj.332.7555.1430","article-title":"Diagnosis and treatment of low back pain","volume":"332","author":"B W Koes","year":"2006","journal-title":"BMJ"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1007\/s00586-008-0602-4","article-title":"European guidelines for the diagnosis and treatment of pelvic girdle pain","volume":"17","author":"A Vleeming","year":"2008","journal-title":"Eur Spine J"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(16)30970-9","article-title":"Non-specific low back pain","volume":"389","author":"C Maher","year":"2017","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/01.AOG.0000129403.54061.0e","article-title":"Low back pain during pregnancy: prevalence, risk factors, and outcomes","volume":"104","author":"S M Wang","year":"2004","journal-title":"Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1089\/jwh.2017.6342","article-title":"The severity and impact of pelvic girdle pain and low-back pain in pregnancy: a multinational study","volume":"27","author":"A Gutke","year":"2018","journal-title":"J Womens Health Larchmt"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1097\/BRS.0b013e31824dcb74","article-title":"Prevalence and factors associated with low back pain and pelvic girdle pain during pregnancy: a multicenter study conducted in the Spanish National Health Service","volume":"37","author":"F M Kovacs","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1080\/00016340601151683","article-title":"Pregnancy-related pelvic girdle pain in the Netherlands","volume":"86","author":"G Van De Pol","year":"2007","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.midw.2016.03.013","article-title":"Women\u2019s experience of low back and\/or pelvic pain (LBPP) during pregnancy","volume":"37","author":"C Close","year":"2016","journal-title":"Midwifery"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"E149","DOI":"10.1097\/01.brs.0000201259.63363.e1","article-title":"Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning","volume":"31","author":"A Gutke","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"2945","DOI":"10.1097\/00007632-199712150-00018","article-title":"Back pain in relation to pregnancy: a 6-year follow-up","volume":"22","author":"H C Ostgaard","year":"1997","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1186\/s12891-016-1154-0","article-title":"Predictors and consequences of long-term pregnancy-related pelvic girdle pain: a longitudinal follow-up study","volume":"17","author":"H Elden","year":"2016","journal-title":"BMC Musculoskelet Disord"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"539","DOI":"10.5435\/JAAOS-D-14-00248","article-title":"Low back pain and pelvic girdle pain in pregnancy","volume":"23","author":"D Casagrande","year":"2015","journal-title":"J Am Acad Orthop Surg"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1097\/00003081-200306000-00024","article-title":"Orthopedic Considerations During Pregnancy","volume":"46","author":"J R Ritchie","year":"2003","journal-title":"Clin Obstet Gynecol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1080\/00016340600578415","article-title":"Risk factors in developing pregnancy-related pelvic girdle pain","volume":"85","author":"H B Albert","year":"2006","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"e0206160","DOI":"10.1371\/journal.pone.0206160","article-title":"Effects of physical activity during pregnancy on preterm delivery and mode of delivery: The Japan Environment and Children\u2019s Study, birth cohort study","volume":"13","author":"M Takami","year":"2018","journal-title":"PloS One"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1186\/s12884-018-2068-7","article-title":"The effect of exercise during pregnancy on gestational diabetes mellitus in normal-weight women: a systematic review and meta-analysis","volume":"18","author":"W K Ming","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/sms.13337","article-title":"Association of sedentary time and physical activity during pregnancy with maternal and neonatal birth outcomes. The GESTAFIT Project","volume":"29","author":"L Baena-Garc\u00eda","year":"2019","journal-title":"Scand J Med Sci Sports"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"2263","DOI":"10.1249\/MSS.0b013e318267ad67","article-title":"Exercise in pregnancy: effect on fitness and obstetric outcomes \u2013 a randomized trial","volume":"44","author":"B B Price","year":"2012","journal-title":"Med Sci Sports Exerc"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"2372","DOI":"10.3109\/14767058.2012.696165","article-title":"Exercise during pregnancy reduces the rate of cesarean and instrumental deliveries: results of a randomized controlled trial","volume":"25","author":"R Barakat","year":"2012","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1136\/bjsports-2018-099821","article-title":"Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis","volume":"53","author":"M H Davenport","year":"2019","journal-title":"Br J Sports Med"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ajog.2014.03.030","article-title":"Effect of physical activity during pregnancy on mode of delivery","volume":"211","author":"I Domenjoz","year":"2014","journal-title":"Am J Obstet Gynecol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1111\/aogs.13351","article-title":"What is the effect of physical activity on duration and mode of delivery? Secondary analysis from the Norwegian Fit for Delivery trial","volume":"97","author":"B Sanda","year":"2018","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1111\/j.1523-536X.2009.00380.x","article-title":"The fetal occiput posterior position: state of the science and a new perspective","volume":"37","author":"P Simkin","year":"2010","journal-title":"Birth"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"573","DOI":"10.7326\/0003-4819-147-8-200710160-00010","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"147","author":"E von Elm","year":"2007","journal-title":"Ann Intern Med"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/00007632-199502000-00016","article-title":"The Quebec Back Pain Disability Scale. Measurement properties","volume":"20","author":"J A Kopec","year":"1995","journal-title":"Spine Phila Pa 1976"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2147\/JPR.S92615","article-title":"Cross-cultural adaption of the German Quebec Back Pain Disability Scale: an exposure-specific measurement for back pain patients","volume":"9","author":"J Riecke","year":"2016","journal-title":"J Pain Res"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00586-003-0615-y","article-title":"Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence","volume":"13","author":"W H Wu","year":"2004","journal-title":"Eur Spine J"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/1471-2474-15-138","article-title":"Evaluation of self-administered tests for pelvic girdle pain in pregnancy","volume":"15","author":"M Fagevik Olsen","year":"2014","journal-title":"BMC Musculoskelet Disord"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.jmpt.2012.04.004","article-title":"Prevalence of low back and pelvic pain during pregnancy in a Norwegian population","volume":"35","author":"S Malmqvist","year":"2012","journal-title":"J Manip Physiol Ther"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"351","DOI":"10.3233\/BMR-140527","article-title":"Women\u2019s experiences of low back pain during pregnancy","volume":"28","author":"M J Mota","year":"2015","journal-title":"J Back Musculoskelet Rehabil"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ijgo.2010.10.030","article-title":"Specific exercises to treat pregnancy-related low back pain in a South African population","volume":"113","author":"J Kluge","year":"2011","journal-title":"Int J Gynaecol Obstet"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1186\/1756-0500-7-686","article-title":"Pelvic girdle pain affects the whole life \u2013 a qualitative interview study in Norway on women\u2019s experiences with pelvic girdle pain after delivery","volume":"7","author":"J Engeset","year":"2014","journal-title":"BMC Res Notes"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1016\/S0140-6736(18)31927-5","article-title":"Interventions to reduce unnecessary caesarean sections in healthy women and babies","volume":"392","author":"A P Betr\u00e1n","year":"2018","journal-title":"Lancet"},{"key":"ref35","first-page":"CD002006","article-title":"Position in the second stage of labour for women without epidural anaesthesia","volume":"5","author":"J K Gupta","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ejogrb.2016.11.006","article-title":"Position for labor and birth: state of knowledge and biomechanical perspectives","volume":"208","author":"D Desseauve","year":"2017","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1002\/ejp.838","article-title":"Neuropathic low back pain in clinical practice","volume":"20","author":"R Baron","year":"2016","journal-title":"Eur J Pain Lond Engl"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1177\/204946370800200205","article-title":"The Pain of Labour","volume":"2","author":"S Labor","year":"2008","journal-title":"Rev Pain"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"445","DOI":"10.3109\/09513591003632092","article-title":"Menstrual abnormalities and predisposition to pregnancy-related hypertensive disorders: a retrospective study","volume":"26","author":"A Fruscalzo","year":"2010","journal-title":"Gynecol Endocrinol"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.rehab.2017.09.005","article-title":"Pregnancy-related low back pain in women in Turkey: prevalence and risk factors","volume":"61","author":"S Sencan","year":"2018","journal-title":"Ann Phys Rehabil Med"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ajog.2012.12.002","article-title":"Mode of delivery and persistence of pelvic girdle syndrome 6 months postpartum","volume":"208","author":"E K Bjelland","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.ajog.2013.02.048","article-title":"Pregnancy-related lumbopelvic pain: what have we learned?","volume":"208","author":"C M Fitzgerald","year":"2013","journal-title":"Am J Obstet Gynecol"},{"key":"ref43","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1016\/j.midw.2013.01.002","article-title":"Maternal experience of musculoskeletal pain during pregnancy and birth outcomes: significance of lower back and pelvic pain","volume":"29","author":"A Brown","year":"2013","journal-title":"Midwifery"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3109\/00016349109006172","article-title":"The impact of low back and pelvic pain in pregnancy on the pregnancy outcome","volume":"70","author":"H C Ostgaard","year":"1991","journal-title":"Acta Obstet Gynecol Scand"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.1523-536X.1994.tb00913.x","article-title":"The cesarean section rate in Sweden: the end of the rise","volume":"21","author":"T F Nielsen","year":"1994","journal-title":"Birth"}],"container-title":["Zeitschrift f\u00fcr Geburtshilfe und Neonatologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1553-4856.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T23:35:18Z","timestamp":1649806518000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1553-4856"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,25]]},"references-count":44,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2022,4,12]]},"published-print":{"date-parts":[[2022,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1553-4856","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0948-2393","1439-1651"],"issn-type":[{"value":"0948-2393","type":"print"},{"value":"1439-1651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,25]]}}}