Pregnancy induces profound physiological changes, including hormonal fluctuations and weight gain, which can exacerbate musculoskeletal issues like lower back pain. Physical inactivity during pregnancy is a known risk factor for various complications, and thyroid function abnormalities, such as hypothyroidism, further complicate maternal health.
In this cohort study, researchers enrolled 420 pregnant women with an average age of 26.333 ± 5.820 years. Participants were initially screened with the question: "Do you have any plans for pregnancy in the next month?" Those who responded affirmatively underwent further evaluations. Physical activity levels and pain intensity were assessed using the International Physical Activity Questionnaire Short Form (IPAQ-S) and Visual Analogue Scale, respectively. Serum thyroid-stimulating hormone (TSH) levels were measured using automated chemiluminescence assays and commercial kits. Assessments were conducted at four points: before pregnancy and during the first, second, and third trimesters.
The key findings of the study were as follows:
• Women who reported LBP demonstrated lower engagement in physical activities compared to those without LBP. This association was consistent across all trimesters.
• Pregnant women with LBP experienced significantly higher weight gain during the second and third trimesters compared to their counterparts without LBP (p < 0.05).
• Women with low physical activity levels had notably higher TSH levels throughout pregnancy compared to those with moderate to high physical activity (p < 0.05). There were no significant differences in body mass index (BMI) related to TSH levels.
• Factors such as physical inactivity (before pregnancy: OR 1.11, 95% CI 0.89-1.22; first trimester: OR 1.09, 95% CI 1.02-1.59; second trimester: OR 0.92, 95% CI 0.87-1.31; third trimester: OR 1.12, 95% CI 1.02-1.39), TSH levels (OR 0.85, 95% CI 0.57-1.29), and weight gain (second trimester: OR 0.87, 95% CI 0.92-1.59; third trimester: OR 1.44, 95% CI 1.02-1.98; p < 0.05) were identified as predictors of increased pain intensity during pregnancy.
Researchers observed that physical inactivity, elevated TSH levels, and higher weight gain predicted increased pain intensity throughout pregnancy. These findings underscore the importance of health-oriented interventions aimed at promoting physical activity, maintaining thyroid function, and managing weight gain in pregnant women to alleviate lower back pain and enhance maternal well-being.
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