Combined oral contraceptives do not increase the risk of back and pelvic pain during pregnancy or after delivery.
OBJECTIVE
To elucidate whether the duration of previous use of combined oral contraceptives (COC) is associated with disabling back or pelvic pain during pregnancy and pain persisting eight months after delivery.


METHODS
Questionnaires were distributed to a group of women at 36 weeks of pregnancy and eight months after their delivery. There were no exclusion criteria. Disabling pain was defined as moderate or severe pain restricting physical activity. Multiple logistic regression analysis of disabling pain during pregnancy and persistent pain after delivery comprised the duration of COC use adjusted for age, pain in a previous pregnancy and a history of back pain when not pregnant.


RESULTS
The study comprised 161 women. Pain during pregnancy was classified as disabling in 57 of the women (35%), pain in a previous pregnancy being a risk factor, odds ratio (OR) 5.0 (95% CI 2.1; 12.1), whereas no association was found with the duration of COC use. Persistent pain eight months after delivery was reported by 41 women (26%), risk factors being a history of back pain when not pregnant; OR 7.5 (2.8; 19.5), disabling pain in the recent pregnancy; OR 5.0 (1.9; 13.4), and short use of COC; 0-<1 year; OR 4.2 (1.3; 12.9), 1-<5 years; OR 4.6 (1.5; 14.4) (reference=>10 years).


CONCLUSIONS
The results indicate that non- or short term users of COC have an increased risk of persistent pain after delivery compared to long term users. No association was found between the duration of COC use and back or pelvic pain during pregnancy.
Björklund
K
K
Department of Women's and Children's Health, Section of Obstetrics and Gynecology, Uppsala University, Sweden.
Nordström
M L
ML
Odlind
V
V
D000328:Adult; D001416:Back Pain / Q000139:chemically induced* / Q000209:etiology; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017699:Pelvic Pain / Q000139:chemically induced* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
D003277:Contraceptives, Oral, Combined