Predictive Factors for Pregnancy-Related Persistent Pelvic Girdle Pain (PPGP): A Systematic Review
Abstract
:1. Introduction
2. Objective
3. Methods
3.1. Study Selection
- PEDRO simple search: Pelvic girdle pain pregnancy: 34 papers (26 RCT, 8 SR).
- COCHRANE: Pelvic girdle pain: 1 Cochrane protocol with 127 trials.
- CINAHL ((pelvic girdle pain OR pelvic girdle pain pregnancy-related OR pelvic girdle pain postpartum)) AND (risk factors or contributing factors or predisposing factors): 150 papers.
- SCOPUS (TITLE-ABS-KEY (pelvic AND girdle AND pain OR pelvic AND girdle AND pain AND pregnancy-related OR pelvic AND girdle AND pain AND postpartum) AND TITLE-ABS-KEY (risk AND factors)): 32 papers.
- WEB OF SCIENCE ((pelvic girdle pain OR pelvic girdle pain pregnancy-related OR pelvic girdle pain postpartum)) AND (risk factors or contributing factors or predisposing factors): 158 papers.
3.2. Assessment of Risk of Bias
4. Data Synthesis
5. Results
Study Selection and Characteristics
6. Risk of Bias of Included Studies
7. Synthesis of Results
8. Principal Findings
9. Comparison with Existing Literature
10. Strengths and Limitations
11. Conclusions and Implication
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Registration
Review Protocol
Abbreviations
PGP | Pelvic Girdle Pain |
PPGP | Pregnancy-Related Pelvic Girdle Pain |
PLB | Pregnancy-Related Low Back Pain |
LPP | Lumbopelvic Pain |
PGS | Pelvic Girdle Syndrome |
SIJ | Sacroiliac Joints |
LDL | Long Dorsal Sacroiliac Ligament |
P4 | Posterior Pelvic Pain Provocation Test |
ASLR | Active Straight Leg Raise |
BMI | Body Mass Index |
VAS | Visual Analogic Scale |
PPT | Pain Pressure Threshold |
PMI | Pregnancy Mobility Index |
PSS | Perceived Stress Scale |
DRI | Disability Rating Index |
ODI | Oswestry Disability Index |
PGQ | Pelvic Girdle Questionnaire |
HR-Qol | Health Related Quality of Life |
EQ-5D | EuroQol |
SF-36 | Short Form-36 Health Survey |
SRH | Self-Rated Health |
NHP | Nottingham Health Profile |
PCS | Pain Catastrophizing Scale |
PSQI | Pittsburgh Sleep Quality Index |
FABQ | Fear-Avoidance Beliefs Questionnaire |
NHP | Nottingham Health Profile |
McGill | McGill Pain Questionnaire |
NP | Neck Pain |
TC | Thoracic Pain |
ROB | Risk of Bias |
QUIPS | Quality In Prognosis Studies Tool |
OR | Odd Ratio |
RR | Relative Risk |
HR | Hazard Ratio |
CI | Confidence Interval |
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Articles Included or Excluded | Inclusion | Exclusion Reason |
---|---|---|
Sjodahl, 2013 [13] | No | Lack of primary outcome (VAS). Baseline time to follow-up does not satisfy our criteria. |
Van den Berg, 2012 [14] | No | Population from clinical trial. |
Albert, 2001 [15] | Yes | |
Olsson, 2012 A [16] | No | Primary outcome: catastrophization. |
Eisenach, 2008 [17] | No | First follow-up 8 weeks postpartum. |
Vollestad, 2009 [18] | No | Population from clinical trial. |
Elden, 2016 [2] | No | Population from clinical trial. Baseline time to follow-up not clear. |
Beales, 2018 [19] | Yes | |
Bergström, 2014 [20] | Yes | |
Bergström, 2016 [21] | No | Primary outcomes do not satisfy our criteria. |
Bergström, 2017 [22] | Yes | |
Bjelland, 2012 [23] | No | Primary outcome evaluated like numbers of painful points. |
Robinson, 2010 B [24] | Yes | |
Gausel, 2015 [25] | Yes | |
Olsson, 2012 B [16] | Yes | |
Robinson, 2010 A [26] | No | Lack of postpartum follow-up. |
Robinson, 2014 C [27] | Yes | |
Gausel, 2020 [11] | No | Follow-up does not satisfy our criteria. |
Ceprnja, 2021 [28] | No | Cross-sectional design. |
Lindgren, 2014 [29] | No | Unclear terminology (back pain). |
Bergström, 2019 [30] | No | Cross-sectional design. |
Lardon, 2018 [31] | No | Primary and secondary outcomes do not satisfy our criteria. |
Rost, 2006 [32] | No | Therapeutical intervention. |
Fernando, 2020 [33] | Yes | |
Munro, 2017 [34] | No | Primary outcome body pain, not specific for PPGP. Full text in French. |
Xiangsheng, 2021 [35] | Yes | |
Kovacs, 2012 [36] | No | Cross-sectional design. |
Bakker, 2013 [37] | No | Lack of postpartum follow-up. |
Assessment Risk of bias Included Articles through QUIPS Tool | |||||||
---|---|---|---|---|---|---|---|
Articles | Study Participation | Study Attrition | Predictive Factor Measurement | Outcome Measurement | Study Confounding | Statistical Analysis and Reporting | Overall |
Albert, 2001 [15] | − | − | +/− | − | + | +/− | Moderate risk of bias |
Beales, 2018 [19] | − | − | − | − | + | − | Low risk of bias |
Bergström, 2014 [20] | − | + | +/− | − | +/− | − | Moderate risk of bias |
Bergström, 2017 [22] | − | − | − | − | + | − | Low risk of bias |
Robinson, 2010 [24] | +/− | + | − | − | + | − | Moderate risk of bias |
Gausel, 2015 [25] | − | + | − | − | + | − | Low risk of bias |
Olsson, 2012 [16] | − | +/− | − | − | − | − | Low risk of bias |
Robinson, 2014 [27] | − | − | +/− | − | +/− | − | Low risk of bias |
Fernando, 2020 [33] | +/− | + | − | +/− | − | − | Moderate risk of bias |
Xiangsheng, 2021 [35] | +/− | + | − | − | +/− | − | Moderate risk of bias |
Prognostic Factor | OR/RR | p Value | References |
---|---|---|---|
Pain | |||
High pain (VAS ≥ 6) | RR = 1.6 | p < 0.05 | Albert, 2001 [15] |
High sacral PPT | RR = 3.24 | p = 0.008 (personal communication) | Bergström, 2014 [20] |
Widespread pain | Spearman rho = −0.384 | p = 0.040 | Beales, 2018 [19] |
OR = 2.03 | p = 0.03 | ||
Provocation tests | |||
High number of +test | RR = 10.7 (>16 + response) | p < 0.001 | Albert, 2001 [15] |
OR = 5.0 (6–8 + test) | p = 0.002 | Robinson, 2010 [24] | |
Disability | |||
High pregnancy disability | |||
OR = 4.03 | p = 0.08 | Bergström, 2017 [22] | |
OR = 5.2 | p < 0.002 | Gausel, 2015 [25] | |
HR = 2.14 | p = 0.072 | Olsson, 2012 [16] | |
LPP/NP/TP | |||
OR = 2.47 | p < 0.030 | Bergström, 2014 [20] | |
History LPP | Spearman rho = 0.09 | p < 0.05 | Robinson, 2010 [24] |
OR = 2.8 | p = 0.017 | Gausel, 2015 [25] | |
History NP/TP | |||
OR = 2.50 | p = 0.002 | Bergström, 2017 [22] | |
Fear | |||
High fear avoidance | OR = 1.06 | p = 0.03 | Fernando, 2020 [33] |
Behavior | |||
Neuroticism | OR = 2.03 | p < 0.001 | Xiangsheng, 2021 [35] |
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Share and Cite
Burani, E.; Marruganti, S.; Giglioni, G.; Bonetti, F.; Ceron, D.; Cozzi Lepri, A. Predictive Factors for Pregnancy-Related Persistent Pelvic Girdle Pain (PPGP): A Systematic Review. Medicina 2023, 59, 2123. https://doi.org/10.3390/medicina59122123
Burani E, Marruganti S, Giglioni G, Bonetti F, Ceron D, Cozzi Lepri A. Predictive Factors for Pregnancy-Related Persistent Pelvic Girdle Pain (PPGP): A Systematic Review. Medicina. 2023; 59(12):2123. https://doi.org/10.3390/medicina59122123
Chicago/Turabian StyleBurani, Elisa, Sharon Marruganti, Gloria Giglioni, Francesca Bonetti, Daniele Ceron, and Alessandro Cozzi Lepri. 2023. "Predictive Factors for Pregnancy-Related Persistent Pelvic Girdle Pain (PPGP): A Systematic Review" Medicina 59, no. 12: 2123. https://doi.org/10.3390/medicina59122123