Association between sleep disturbance and low back and pelvic pain in 4-month postpartum women: A cross-sectional study

Abstract

Purpose: Persistent low back and pelvic pain (LBPP) is a postpartum-specific health problem. Sleep disturbances' association with persistent LBPP is not yet clear. We aimed to examine the cross-sectional association between sleep disturbance and persistent LBPP at 4 months postpartum.

Methods: We enrolled 120 women with LBPP during pregnancy (mean age, 31.8; standard deviation, 4.9 years). The primary outcome was persistent LBPP. We assessed LBPP severity at 4 months postpartum using the Numerical Rating Scale (NRS), where women with an NRS score of ≥ 4 at 4 months postpartum were allocated to the persistent LBPP group. We assessed sleep disturbance at 4 months postpartum using the Japanese version of the Pittsburgh Sleep Quality Index with a total score of ≥ 6 indicating sleep disturbance. Moreover, we performed univariate and multiple logistic regression analyses to examine the cross-sectional association of sleep disturbance with persistent LBPP. The relevant confounding variables were age, body mass index, parity, and history of LBPP before pregnancy.

Results: Among the 120 women, 45 women had persistent LBPP (37.5%) with 32 (71.1%) of them reporting sleep disturbance. There was a significant association of sleep disturbance with persistent LBPP (odds ratio [OR], 2.81; 95% confidence interval [95% CI], 1.28-6.19), which remained after adjustments for confounding variables (OR, 2.98; 95% CI, 1.31-6.75).

Conclusion: Our findings indicate that sleep disturbance is associated with persistent LBPP at 4 months postpartum; therefore, it should be taken into consideration in postpartum women with persistent LBPP.

Keywords: Low back pain; Pelvic girdle pain; Persistent pain; Postpartum; Sleep disturbance.