{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:51:28Z","timestamp":1789843888883,"version":"4.0.1"},"reference-count":46,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"XI Research Call of the University Camilo Jose\u0301 Cela","award":["87482766"],"award-info":[{"award-number":["87482766"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Postpartum lumbopelvic pain (PLPP) is a common condition that negatively affects many women\u2019s quality of life. We aimed to analyze the influence of emotional well-being, kinesiophobia, and sleep quality as predictors of PLPP during the first year postpartum. Materials and Methods: A cross-sectional study was conducted with 192 women in their first year postpartum. Validated questionnaires were administered to evaluate pain (Oswestry Disability Index, ODI), postpartum depression (PPD) (Edinburgh Postnatal Depression Scale, EPDS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), and kinesiophobia (Tampa Scale of Kinesiophobia, TSK-11). Bivariate correlations and binary logistic regression were performed to identify predictors of PLPP. Results: Overall, 42.2% of participants reported lumbopelvic pain. The prevalence of postpartum depressive symptoms was 59.9%, and kinesiophobia was present in 30.7% of women with pain. Both PPD and kinesiophobia were significantly associated with the presence of PLPP (p &lt; 0.001). In the multivariate model, depression was the main predictor (OR = 8.1), followed by kinesiophobia (OR = 3.6). Sleep quality was not an independent predictor but may be related to PLPP through indirect mechanisms. No significant associations were found with sociodemographic, obstetric, or lifestyle variables. Conclusions: PPD and kinesiophobia are key factors in the occurrence of PLPP, while sleep quality may act as a mediating variable. These findings highlight the need for postnatal interventions addressing emotional health and fear of movement to improve the prevention and management of lumbopelvic pain in this population.<\/jats:p>","DOI":"10.3390\/medicina61101869","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T13:07:22Z","timestamp":1760706442000},"page":"1869","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Psychological and Behavioral Predictors of Postpartum Lumbopelvic Pain: A Multivariate Analysis"],"prefix":"10.3390","volume":"61","author":[{"given":"Ignacio","family":"Jim\u00e9nez-de-Ory","sequence":"first","affiliation":[{"name":"Physiotherapy and Health Research Group (FYSA), Department of Physiotherapy, Faculty of Health Sciences\u2014HM Hospitals, University Camilo Jose\u0301 Cela, Villanueva de la Can\u0303ada, 28692 Madrid, Spain"},{"name":"HM Hospitals Health Research Institute, 28015 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Mazur","sequence":"additional","affiliation":[{"name":"Physiotherapy and Health Research Group (FYSA), Department of Physiotherapy, Faculty of Health Sciences\u2014HM Hospitals, University Camilo Jose\u0301 Cela, Villanueva de la Can\u0303ada, 28692 Madrid, Spain"},{"name":"HM Hospitals Health Research Institute, 28015 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8740-1226","authenticated-orcid":false,"given":"\u00c1ngel","family":"Oliva-Pascual-Vaca","sequence":"additional","affiliation":[{"name":"Instituto de Biomedicina de Sevilla (IBiS), Departamento de Fisioterapia, Universidad de Sevilla, 41013 Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3592-0056","authenticated-orcid":false,"given":"Mari\u0301a","family":"Benito-de-Pedro","sequence":"additional","affiliation":[{"name":"Physiotherapy and Health Research Group (FYSA), Department of Physiotherapy, Faculty of Health Sciences\u2014HM Hospitals, University Camilo Jose\u0301 Cela, Villanueva de la Can\u0303ada, 28692 Madrid, Spain"},{"name":"HM Hospitals Health Research Institute, 28015 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4271-2415","authenticated-orcid":false,"given":"Tom\u00e1s","family":"Fern\u00e1ndez-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Physiotherapy and Health Research Group (FYSA), Department of Physiotherapy, Faculty of Health Sciences\u2014HM Hospitals, University Camilo Jose\u0301 Cela, Villanueva de la Can\u0303ada, 28692 Madrid, Spain"},{"name":"HM Hospitals Health Research Institute, 28015 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4289-9299","authenticated-orcid":false,"given":"Elena Sonsoles","family":"Rodri\u0301guez-Lo\u0301pez","sequence":"additional","affiliation":[{"name":"Physiotherapy and Health Research Group (FYSA), Department of Physiotherapy, Faculty of Health Sciences\u2014HM Hospitals, University Camilo Jose\u0301 Cela, Villanueva de la Can\u0303ada, 28692 Madrid, Spain"},{"name":"HM Hospitals Health Research Institute, 28015 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1111\/j.1526-4637.2012.01424.x","article-title":"Pregnancy-related lumbopelvic pain: Prevalence, risk factors, and profile in Kuwait","volume":"13","author":"Salem","year":"2012","journal-title":"Pain Med."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Burani, E., Marruganti, S., Giglioni, G., Bonetti, F., Ceron, D., and Cozzi Lepri, A. (2023). Predictive Factors for Pregnancy-Related Persistent Pelvic Girdle Pain (PPGP): A Systematic Review. Medicina, 59.","DOI":"10.3390\/medicina59122123"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1007\/s00586-020-06288-9","article-title":"Subjective recovery from pregnancy-related pelvic girdle pain during the first 6 weeks after delivery: A prospective longitudinal cohort study","volume":"29","author":"Gausel","year":"2020","journal-title":"Eur. Spine J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1016\/j.jos.2023.10.006","article-title":"Gap between the prevalence of and consultation rate for lumbopelvic pain in postnatal Japanese women","volume":"29","author":"Iguchi","year":"2024","journal-title":"J. Orthop. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Elden, H., Gutke, A., Kjellby-Wendt, G., Fagevik-Olsen, M., and \u00d6stgaard, H.C. (2016). Predictors and consequences of long-term pregnancy-related pelvic girdle pain: A longitudinal follow-up study. BMC Musculoskelet. Disord., 17.","DOI":"10.1186\/s12891-016-1154-0"},{"key":"ref_6","first-page":"33","article-title":"Pelvic girdle pain during or after pregnancy: A review of recent evidence and a clinical care path proposal","volume":"5","author":"Verstraete","year":"2013","journal-title":"Facts Views Vis. Obgyn."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1097\/JWH.0000000000000236","article-title":"Clinical Practice Guidelines for Pelvic Girdle Pain in the Postpartum Population","volume":"46","author":"Simonds","year":"2022","journal-title":"J. Women\u2019s Health Phys. Ther."},{"key":"ref_8","first-page":"e202301002","article-title":"Fisioterapia en las secuelas del parto por ces\u00e1rea: Una revisi\u00f3n sistem\u00e1tica","volume":"97","year":"2023","journal-title":"Rev. Esp. Salud Publica"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e187638632308010","DOI":"10.2174\/18763863-v16-230825-2023-5","article-title":"Prevalence and Characteristics of Women with Persistent LBP Postpartum","volume":"16","author":"Madzivhandila","year":"2023","journal-title":"Open Pain J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1007\/s00586-010-1487-6","article-title":"Impact of postpartum lumbopelvic pain on disability, pain intensity, health-related quality of life, activity level, kinesiophobia, and depressive symptoms","volume":"20","author":"Gutke","year":"2011","journal-title":"Eur. Spine J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.math.2015.04.016","article-title":"Disturbed body perception, reduced sleep, and kinesiophobia in subjects with pregnancy-related persistent lumbopelvic pain and moderate levels of disability: An exploratory study","volume":"21","author":"Beales","year":"2016","journal-title":"Man. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Remus, A., Smith, V., Gutke, A., Mena, J.J.S., M\u00f8rkved, S., Wikmar, L.N., \u00d6berg, B., Olsson, C., Robinson, H.S., and Stuge, B. (2021). A core outcome set for research and clinical practice in women with pelvic girdle pain: PGP-COS. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0247466"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.jclinepi.2016.02.031","article-title":"Adequate sample size for developing prediction models is not simply related to events per variable","volume":"76","author":"Ogundimu","year":"2016","journal-title":"J. Clin. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Starzec-Proserpio, M., W\u0119grzynowska, M., Sys, D., Kajdy, A., Rongies, W., and Baranowska, B. (2022). Prevalence and factors associated with postpartum pelvic girdle pain among women in Poland: A prospective, observational study. BMC Musculoskelet. Disord., 23.","DOI":"10.1186\/s12891-022-05864-y"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"E430","DOI":"10.1097\/BRS.0000000000002867","article-title":"Psychometric Properties Study of the Oswestry Disability Index in a Spanish Population with Previous Lumbar Disc Surgery: Homogeneity and Validity","volume":"44","author":"Ferrara","year":"2019","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1007\/s00296-014-2960-z","article-title":"Reliability and validity of the Spanish version of the Pittsburgh Sleep Quality Index (PSQI) in patients with fibromyalgia","volume":"34","author":"Garrido","year":"2014","journal-title":"Rheumatol. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1007\/s00404-022-06525-0","article-title":"Predictive validity of the Edinburgh Postnatal Depression Scale and other tools for screening depression in pregnant and postpartum women: A systematic review and meta-analysis","volume":"307","author":"Park","year":"2023","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_18","first-page":"174","article-title":"Factor structure of the Spanish version of the Edinburgh Postnatal Depression Scale","volume":"46","author":"Labad","year":"2018","journal-title":"Actas Esp. Psiquiatr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.jpain.2010.08.004","article-title":"Psychometric properties of the Spanish version of the Tampa Scale for Kinesiophobia (TSK)","volume":"12","year":"2011","journal-title":"J. Pain."},{"key":"ref_20","first-page":"69","article-title":"Statistics corner: A guide to appropriate use of correlation coefficient in medical research","volume":"24","author":"Mukaka","year":"2012","journal-title":"Malawi Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1007\/s00586-013-2716-6","article-title":"Predictors for long-term disability in women with persistent postpartum pelvic girdle pain","volume":"22","author":"Gutke","year":"2013","journal-title":"Eur. Spine J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.jogc.2019.08.030","article-title":"Prevalence of Low Back Pain, Pelvic Girdle Pain, and Combination Pain in a Postpartum Ontario Population","volume":"42","author":"Tavares","year":"2020","journal-title":"J. Obstet. Gynaecol. Can."},{"key":"ref_23","first-page":"454","article-title":"Trajectories of lower back, upper back, and pelvic girdle pain during pregnancy and early postpartum in primiparous women","volume":"29","author":"Egger","year":"2019","journal-title":"Women\u2019s Health Issues"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"100929","DOI":"10.1016\/j.srhc.2023.100929","article-title":"\u201cThe ignored pain\u201d\u2014Experiences of encounters with healthcare from the perspective of women with pain persisting after childbirth\u2014A qualitative study","volume":"39","author":"Molin","year":"2024","journal-title":"Sex Reprod. Healthc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"103808","DOI":"10.1016\/j.midw.2023.103808","article-title":"Prevalence of postpartum major depression and depressive symptoms in Spanish women: A longitudinal study up to 1 year postpartum","volume":"126","year":"2023","journal-title":"Midwifery"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Flor-Alemany, M., Migueles, J.H., Alemany-Arrebola, I., Aparicio, V.A., and Baena-Garc\u00eda, L. (2022). Exercise, Mediterranean Diet Adherence or Both during Pregnancy to Prevent Postpartum Depression\u2014GESTAFIT Trial Secondary Analyses. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192114450"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1038\/s44220-024-00217-1","article-title":"Prolonged HPA axis dysregulation in postpartum depression associated with adverse early life experiences: A cross-species translational study","volume":"2","author":"Niwa","year":"2024","journal-title":"Nat. Ment. Health"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Virgara, R., Maher, C., and Van Kessel, G. (2018). The comorbidity of low back pelvic pain and risk of depression and anxiety in pregnancy in primiparous women. BMC Pregnancy Childbirth, 18.","DOI":"10.1186\/s12884-018-1929-4"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Long, G., Yao, Z.Y., Na, Y., Ping, Y., Wei, S., and Mingsheng, T. (2020). Different types of low back pain in relation to pre- and post-natal maternal depressive symptoms. BMC Pregnancy Childbirth, 20.","DOI":"10.1186\/s12884-020-03139-9"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"110280","DOI":"10.1016\/j.jpsychores.2020.110280","article-title":"Bidirectional relationship between physical health symptoms and depressive symptoms in the pre- and postpartum period","volume":"139","author":"Cumsille","year":"2020","journal-title":"J. Psychosom. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1080\/16501970510041253","article-title":"Kinesiophobia among patients with musculoskeletal pain in primary healthcare","volume":"38","author":"Lundberg","year":"2006","journal-title":"J. Rehabil. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.math.2012.11.001","article-title":"Thinking beyond muscles and joints: Therapists\u2019 and patients\u2019 attitudes and beliefs regarding chronic musculoskeletal pain are key to applying effective treatment","volume":"18","author":"Nijs","year":"2013","journal-title":"Man. Ther."},{"key":"ref_33","first-page":"305","article-title":"The Relationship between Fear-Avoidance Beliefs and Pain in Pregnant Women with Pelvic Girdle Pain: A Cross-Sectional Study","volume":"6","author":"Simbar","year":"2018","journal-title":"Int. J. Community Based Nurs. Midwifery"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s10865-018-9950-7","article-title":"Poor sleep quality increases symptoms of depression and anxiety in postpartum women","volume":"41","author":"Okun","year":"2018","journal-title":"J. Behav. Med."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Lewis, B.A., Gjerdingen, D., Schuver, K., Avery, M., and Marcus, B.H. (2018). The effect of sleep pattern changes on postpartum depressive symptoms. BMC Womens Health, 18.","DOI":"10.1186\/s12905-017-0496-6"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Nasreen, H.E., Kabir, Z.N., Forsell, Y., and Edhborg, M. (2010). Low birth weight in offspring of women with depressive and anxiety symptoms during pregnancy: Results from a population based study in Bangladesh. BMC Public Health, 10.","DOI":"10.1186\/1471-2458-10-515"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1001\/jamapsychiatry.2016.0934","article-title":"Neonatal Outcomes in Women with Untreated Antenatal Depression Compared with Women Without Depression: A Systematic Review and Meta-analysis","volume":"73","author":"Jarde","year":"2016","journal-title":"JAMA Psychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1007\/s10995-014-1637-2","article-title":"Prenatal depression and adverse birth outcomes: An updated systematic review","volume":"19","author":"Accortt","year":"2015","journal-title":"Matern. Child Health J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s13690-022-00792-8","article-title":"Effect of perinatal depression on birth and infant health outcomes: A systematic review and meta-analysis of observational studies from Africa","volume":"80","author":"Dadi","year":"2022","journal-title":"Arch. Public Health"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1001\/jamapsychiatry.2017.4363","article-title":"Association of persistent and severe postnatal depression with child outcomes","volume":"75","author":"Netsi","year":"2018","journal-title":"JAMA Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"102152","DOI":"10.1016\/j.msksp.2020.102152","article-title":"Understanding and managing pelvic girdle pain from a person-centred biopsychosocial perspective","volume":"48","author":"Beales","year":"2020","journal-title":"Musculoskelet. Sci. Pract."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Deegan, O., Fullen, B.M., Segurado, R., and Doody, C. (2024). The effectiveness of a combined exercise and psychological treatment programme on measures of nervous system sensitisation in adults with chronic musculoskeletal pain\u2014A systematic review and meta-analysis. BMC Musculoskelet., 25.","DOI":"10.1186\/s12891-024-07274-8"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.infbeh.2009.10.005","article-title":"Postpartum depression effects on early interactions, parenting, and safety practices: A review","volume":"33","author":"Field","year":"2010","journal-title":"Infant Behav. Dev."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"pzac152","DOI":"10.1093\/ptj\/pzac152","article-title":"Can clinical postpartum muscle assessment help predict the severity of postpartum pelvic girdle pain? A prospective cohort study","volume":"103","author":"Vesting","year":"2022","journal-title":"Phys. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2476046","DOI":"10.1080\/07853890.2025.2476046","article-title":"Educating women to prevent and treat low back and pelvic girdle pain during and after pregnancy: A systematized narrative review","volume":"57","author":"Vesting","year":"2025","journal-title":"Ann. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1007\/s10072-022-06430-z","article-title":"The effect of pelvic floor muscle-strengthening exercises on low back pain: A systematic review and meta-analysis on randomized clinical trials","volume":"44","author":"Kazeminia","year":"2023","journal-title":"Neurol. Sci."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/10\/1869\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T13:58:12Z","timestamp":1760709492000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/10\/1869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":46,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["medicina61101869"],"URL":"https:\/\/doi.org\/10.3390\/medicina61101869","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,17]]}}}