Psychological and Behavioral Predictors of Postpartum Lumbopelvic Pain: A Multivariate Analysis

产后腰骶部疼痛的心理和行为预测因素:一项多变量分析

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Abstract

Background and Objectives: Postpartum lumbopelvic pain (PLPP) is a common condition that negatively affects many women's quality of life. We aimed to analyze the influence of emotional well-being, kinesiophobia, and sleep quality as predictors of PLPP during the first year postpartum. Materials and Methods: A cross-sectional study was conducted with 192 women in their first year postpartum. Validated questionnaires were administered to evaluate pain (Oswestry Disability Index, ODI), postpartum depression (PPD) (Edinburgh Postnatal Depression Scale, EPDS), sleep quality (Pittsburgh Sleep Quality Index, PSQI), and kinesiophobia (Tampa Scale of Kinesiophobia, TSK-11). Bivariate correlations and binary logistic regression were performed to identify predictors of PLPP. Results: Overall, 42.2% of participants reported lumbopelvic pain. The prevalence of postpartum depressive symptoms was 59.9%, and kinesiophobia was present in 30.7% of women with pain. Both PPD and kinesiophobia were significantly associated with the presence of PLPP (p < 0.001). In the multivariate model, depression was the main predictor (OR = 8.1), followed by kinesiophobia (OR = 3.6). Sleep quality was not an independent predictor but may be related to PLPP through indirect mechanisms. No significant associations were found with sociodemographic, obstetric, or lifestyle variables. Conclusions: PPD and kinesiophobia are key factors in the occurrence of PLPP, while sleep quality may act as a mediating variable. These findings highlight the need for postnatal interventions addressing emotional health and fear of movement to improve the prevention and management of lumbopelvic pain in this population.

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