Occupational Lifting and Pelvic Pain during Pregnancy: A Study within the Danish National Birth Cohort

By Larsen, Pernile Stemann; Strandberg-Larsen, Katrine et al. | Scandinavian Journal of Work, Environment & Health, January 2013 | Go to article overview

Occupational Lifting and Pelvic Pain during Pregnancy: A Study within the Danish National Birth Cohort


Larsen, Pernile Stemann, Strandberg-Larsen, Katrine, Juhl, Mette, Svendsen, Susanne Wulff, Bonde, Jens Peter, Andersen, Anne-Marie Nybo, Scandinavian Journal of Work, Environment & Health


Objective Pelvic pain during pregnancy is a common ailment, and the disease is a major cause of sickness absence during pregnancy. It is plausible that occupational lifting may be a risk factor of pelvic pain during pregnancy, but no previous studies have examined this specific exposure. The aim of this study was to examine the association between occupational lifting and pelvic pain during pregnancy.

Methods The study comprised 50 143 pregnant women, enrolled in the Danish National Birth Cohort in the period from 1996-2002. During pregnancy, the women provided information on occupational lifting (weight load and daily frequency), and six months post partum on pelvic pain. Adjusted odds ratios for pelvic pain during pregnancy according to occupational lifting were calculated by logistic regression.

Results Any self-reported occupational lifting (>1 time/day and loads weighing >10 kg) was associated with an increased risk of pelvic pain during pregnancy as compared to no such lifting. A confounder-adjusted exposure-response relation was observed between self-reported total loads lifted and pelvic pain during pregnancy. Daily lifting of both medium (11-20 kg) and heavy loads (>20 kg) were associated with increased risk, and the highest risk was observed among women who lifted heavy loads independent of exposure to medium loads.

Conclusion Occupational lifting may increase the risk of pelvic pain during pregnancy.

Key terms occupation; parity; physical activity; physical workload; pregnant women.

During pregnancy, physical workload may be a risk factor for several adverse pregnancy outcomes, such as spontaneous abortion, stillbirth, pre-term birth, and low birth weight (1). Physical workload may, however, also have a negative impact on maternal health (2-4). About 20% of all pregnant women suffer from pelvic pain, and in Scandinavia the disease is a major cause of sickness absence during pregnancy (5-7). For many women, the disease interferes with the ability to carry out daily activities, and in some cases this progresses to chronic post-partum pain (7-9). The etiology is not well established, and there is a lack of international consensus about the nature of the disease and its identification and classification (7, 10). Over the last decades, the impact of sickness absence on quality of life and the subsequent socioeconomic costs has increased the attention of the medical community on this subject (11).

A few studies have examined the effects of physical workload on the risk of pelvic pain during pregnancy. These studies found that uncomfortable working conditions and physical strenuous workload were associated with increased risk (2, 12, 13). During pregnancy, the extensive biomechanical changes lead to pelvic strain (14), and it is plausible that occupational lifting during pregnancy may increase this strain further. However, no studies have evaluated the effects of occupational lifting specifically. Regular leisure-time physical activity prior to pregnancy is associated with a decreased risk of pelvic pain (15), but during pregnancy it may have the opposite effect.

The aim of this study was to (i) examine the association between occupational lifting and pelvic pain during pregnancy and (ii) study the possible modifying effects of leisure-time physical activity and parity, respectively.

Methods

Study population

This study was based on data from the Danish National Birth Cohort (DNBC). In the period from 1996-2002, 91 386 women, representing 100 418 pregnancies, were enrolled in the cohort. At the first antenatal care visit, the general practitioners briefed participants about the study and provided an informed consent form. By signing the informed consent form, the pregnant women agreed to be interviewed by telephone. The first pregnancy interview took place around the 12-1 6th week of gestation, and - post partum - the women were interviewed when the child was approximately six months. …

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