Introduction

Low back pain (LBP) during pregnancy is a common complaint that affects many women worldwide. Defined as pain occurring between the costal margin and the inferior gluteal fold, LBP can be classified into pelvic girdle pain (PGP) and lumbar pain (LP). PGP typically radiates from the back to the thighs, while LP is primarily localized around the lumbar spine. Understanding the prevalence, risk factors, and clinical profile of LBP in pregnant women is crucial, especially for healthcare providers aiming to enhance maternal care.

Prevalence and Risk Factors

Recent studies show a staggering prevalence of LBP among pregnant women, reported at 71.3% in Spain, 55.4% in Nigeria, and 26.3% in Pakistan. Numbers suggest that this prevalence increases with the progression of pregnancy: approximately 50% in the first trimester, escalating to between 70% and 80% by the third trimester. Key risk factors that have been identified include a history of pelvic trauma, prior episodes of LBP, and obesity. Notably, women who experienced LBP in previous pregnancies are 85% more likely to suffer again.

Hormonal Influences and Postural Considerations

Hormonal changes during pregnancy play a significant role in LBP development. The increase in relaxin, a hormone responsible for softening ligaments and joints, compromises spinal stability. Meanwhile, the growing uterus shifts a woman's center of gravity forward, increasing the stress on the lower back and leading to pain. Additional factors such as poor posture and prolonged sitting can exacerbate the issue.

Recommendations for Management

To tackle the problem, it is advised that women engage in regular physical activity before and during pregnancy. Recommendations also include techniques like posture counseling, stretching, and in some cases, physiotherapy. Despite the significant impact of LBP on daily activities and overall quality of life, many women avoid seeking medical help, often attributing the pain to the pregnancy itself.

Findings from Bamenda Regional Hospital

A recent study conducted at Bamenda Regional Hospital from February to April 2019 provides critical data regarding LBP among pregnant women in Cameroon. The study included 410 women, revealing a prevalence of 53.9%, with LP reported by 34.9% and PGP by 26.1%. Alarmingly, only a small fraction of these women sought medical treatment, primarily due to concerns about medication safety during pregnancy.

Analysis and Insights

The analysis indicated that women with obesity, those who had experienced LBP in previous pregnancies, and those sleeping on soft mattresses had a higher likelihood of developing LBP. Conversely, engaging in exercise during pregnancy significantly reduced these risks.

Conclusion

This study highlights a need for proactive measures in antenatal care. While the effects of LBP are well-documented in many parts of the world, there remains a significant gap in understanding its impact in low- and middle-income regions. Addressing these gaps through education, awareness, and appropriate interventions can greatly improve the quality of care for pregnant women, ultimately enhancing their well-being and pregnancy outcomes.

In summary, low back pain during pregnancy is more than just a discomfort; it's an issue that can hinder a woman's ability to lead normal activities and enjoy her pregnancy. As awareness increases, the hope is that more women will receive the attention and treatment they need to navigate this challenging aspect of pregnancy. Our knowledge of LBP will continue to evolve, but support measures are necessary now to improve maternal health outcomes globally.