Catastrophizing during and after pregnancy: associations with lumbopelvic pain and postpartum physical ability

There is general agreement that persistent low back pain is a problem with major consequences for society as well as the individual. (1) Among women with persistent low back pain, [...]
Background. There is a lack of knowledge about the possible role of catastrophizing in lumbopelvic pain during and after pregnancy and in postpartum physical ability. Objective. The aims of this study were to explore how catastrophizing fluctuates over time during and after pregnancy and to investigate the associations between catastrophizing and lumbopelvic pain and between catastrophizing and postpartum physical ability. Design. A prospective questionnaire was used. Methods. The Pain Catastrophizing Scale was used to assess exaggerated negative thoughts about pain experiences in weeks 19 to 21 and weeks 34 to 37 of pregnancy and at 6 months postpartum. The Disability Rating Index was used to assess physical ability at 6 months postpartum. The occurrence of lumbopelvic pain was reported by participants. Parametric and nonparametric tests were used for the analyses. Results. A total of 242 of 324 women were categorized according to reported levels of catastrophizing. A majority of women (57.9%) reported not catastrophizing at all test occasions, whereas 10.3% reported catastrophizing at all occasions. For the remaining 31.8%, the levels of catastrophizing varied over time. Women who catastrophized at 1 or more of the occasions reported higher proportions of postpartum lumbopelvic pain and had more restricted postpartum physical ability than women who did not catastrophize. Limitations. The fact that some women did not complete the questionnaire at all test occasions might have reduced the generalizability of the results. Conclusions. The common idea that levels of catastrophizing arc 'stable' within personality should be reconsidered, because for 1 of 3 women, the levels of catastrophizing changed over time. A majority of women reported not catastrophizing. However, catastrophizing in relation to pregnancy seems to be associated with lumbopelvic pain and postpartum physical ability. The results indicated that the role of catastrophizing in this context should be studied further.