Impact of job adjustment, pain location and exercise on sick leave due to lumbopelvic pain in pregnancy: a longitudinal study

Abstract

Objective: To identify factors associated with sick leave due to lumbopelvic pain (LPP) in pregnancy.

Design: Prospective cohort study using participants from a randomized controlled trial (RCT) designed to study the effect of exercise during pregnancy on pregnancy related diseases.

Setting: St. Olavs Hospital, Trondheim University Hospital and Stavanger University Hospital, April 2007 to December 2009.

Subjects: Healthy pregnant women.

Main outcome measures: Self-reported sick leave due to LPP in late pregnancy (gestation week 32–36).

Results: In total, 532/716 (74%) women reported LPP at 32–36 weeks of pregnancy, and 197/716 (28%) reported sick leave due to LPP. Not receiving job adjustments when needed (Odds ratio, OR with 95% confidence interval, CI, was 3.0 (1.7–5.4)) and having any pain in the pelvic girdle versus no pain (OR 2.7 (1.3–5.6), OR 2.7 (1.4–5.2) and OR 2.2 (1.04–4.8)) for anterior, posterior and combined anterior and posterior pain in the pelvis respectively, were associated with sick leave due to LPP in late pregnancy. Also higher disability, sick listed due to LPP at inclusion and lower education, were significant explanatory variables. There was a trend of reduced risk for sick leave due to LPP when allocated to the exercise group in the original RCT (OR 0.7 (0.4–1.0)).

Conclusion: Facilitating job adjustments when required might keep more pregnant women in employment. Furthermore, pain locations in pelvic area, disability, lower education and being sick listed due to LPP in mid pregnancy are important risk factors for sick leave in late pregnancy.

Key points

• Current awareness:

• More than half of pregnant women are on sick leave during pregnancy and the most frequently reported cause is lumbopelvic pain.

• This paper adds:

  • Inability to make job adjustments, pain locations in pelvic area, disability and lower education level were the most important risk factors for sick leave in late pregnancy. Facilitating early job adjustment might be a precaution to keep more pregnant women in work. Allocation to an exercise group tended to reduce the risk of sick leave in late pregnancy.Registration number: Clinical trial gov (NCT 00476567).

Keywords:

• Sick leave
• pregnancy
• lumbopelvic pain
• exercise
• job adjustment

Acknowledgements

The authors thank all physiotherapists (Marit Lindland Ree, Wilma van de Veen, Karen Schei, Marte Sundby, Irene Hiim Torjusen and Henriette Tokvam Larsen) and medical secretaries (Elin Ørndahl Holthe and Heidi Larsen) at the two hospitals for their effort in performing this study. We are indebted to the women who participated in this study.

Ethical approval

The Regional Committees for Medical and Health Research Ethics (REK 4.2007.81)

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The trial was supported by the Norwegian Fund for Postgraduate Training in Physiotherapy (7/370-00/05), and the Liaison Committee for Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology.