FOLLOW-UP OF PATIENTS WITH LOW-BACK-PAIN DURING PREGNANCY

Objective: To identify the long-term risk for low back pain among wome n with previous severe low back pain during pregnancy. Methods: In a p revious prospective study, 79 pregnant women developed low back pain s evere enough to require sick leave. Twelve years later a questionnaire was sent to 62 of these women and 84 controls who did not develop sev ere low back pain during pregnancy. The questionnaire asked about occu pation, low back pain in general and during later pregnancies, and sic k leave due to low back pain. There were also questions regarding use of oral contraceptives and its possible relation to low back pain. Res ults: The response rate was 84% in the back pain group and 80% among c ontrols. The two groups were similar according to the percentage of wo men having had another pregnancy (33 of 52 [63%] versus 39 of 67 [58%] ) but ten (19%) of the women with previous low back pain stated they h ad refrained from another pregnancy because of their fear of low back pain compared with only one control. Almost all women (31 of 33) with previous severe low back pain experienced the same symptoms in a subse quent pregnancy, compared with 17 of 39 (44%) controls. Even when they were not pregnant, women with previous low back pain suffered more of ten and used more sick leave due to low back pain (44 of 52 versus 43 of 67, chi(2) = 5.68, P < .05). The location (sacroiliac joint or lumb ar affection) of the previous low back pain did not affect the long-te rm prognosis. In a logistic regression model, previous low back pain d uring pregnancy was the only independent risk factor for low back pain during a subsequent pregnancy, whereas an occupation involving physic al demand did not affect the results. However, together with previous low back pain during pregnancy, heavy occupation increased the risk fo r current nonpregnant low back pain. Conclusion: Women with severe low back pain during pregnancy have an extremely high risk for experienci ng a new episode of severe low back pain during another pregnancy and when not pregnant. (C) 1998 by The American College of Obstetricians a nd Gynecologists.