title: The association between pelvic girdle pain and sick leave during pregnancy; a retrospective study of a Norwegian population.
abstract: BACKGROUND
  The incidence of pelvic girdle pain (PGP) in pregnancy is wide ranged depending on definition, the utilised diagnostic means, and the design of the studies. PGP during pregnancy has negative effects on activities of daily living and causes long sick leave, which makes it a major public health issue. Our objectives were to explore the frequency of sick leave in pregnancy due to PGP, assess the relationship between different types of pain-related activities of daily living, examine physical workload, type of work in relation to sick leave, and to explore factors that make women less likely to take sick leave for PGP.
  
  
  METHODS
  All women giving birth at the maternity ward of Stavanger University Hospital, Norway, were asked to participate and complete a questionnaire on demographic features, PGP, pain-related activities of daily living, sick leave in general and for PGP, frequency of exercising before and during pregnancy. Drawings of pelvic girdle and low back area were used for the localization of pain. PGP intensity was then rated retrospectively on a numerical rating scale. Non-parametric tests, multinomial logistic regression and sequential linear regression analysis were used in the statistical analysis.
  
  
  RESULTS
  PGP is a frequent and major cause of sick leave during pregnancy among Norwegian women, which is also reflected in activities of daily living as measured with scores on all Oswestry disability index items. In the multivariate analysis of factors related to sick leave and PGP we found that work satisfaction, problems with lifting and sleeping, and pain intensity were risk factors for sick leave. In addition, women with longer education, higher work satisfaction and fewer problems with sitting, walking and standing, were less likely to take sick leave in pregnancy, despite the same pain intensity as women being on sick leave.
  
  
  CONCLUSIONS
  A coping factor in pregnant women with PGP was discovered, most likely dependant on education, associated with work situation and/or work posture, which decreases sick leave. We recommend these issues to be further examined in a prospective longitudinal study since it may have important implications for sick leave frequency during pregnancy.
authors.affiliation: Department of Health Studies, University of Stavanger, Stavanger, Norway. stefmalm@gmail.com.|Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway. stefmalm@gmail.com.
authors.forename: Stefan
authors.initials: S
authors.lastname: Malmqvist
authors.affiliation: Private practice, Kristiansand, Norway. ikjaermann@yahoo.no.
authors.forename: Inger
authors.initials: I
authors.lastname: Kjaermann
authors.affiliation: Department of Health Studies, University of Stavanger, Stavanger, Norway. knut.andersen@sus.no.|Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway. knut.andersen@sus.no.
authors.forename: Knut
authors.initials: K
authors.lastname: Andersen
authors.affiliation: Department of Obstetrics and Gynaecology, Stavanger University Hospital, Stavanger, Norway. inger.okland@sus.no.
authors.forename: Inger
authors.initials: I
authors.lastname: Økland
authors.affiliation: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway. jan.petter.larsen@sus.no.
authors.forename: Jan Petter
authors.initials: JP
authors.lastname: Larsen
authors.affiliation: Network for Medical Sciences, University of Stavanger, Stavanger, Norway. bronnick@gmail.com.
authors.forename: Kolbjørn
authors.initials: K
authors.lastname: Brønnick
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D004185:Disability Evaluation; D004522:Educational Status; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D017770:Lifting; D009664:Norway / Q000453:epidemiology; D010147:Pain Measurement; D059388:Pelvic Girdle Pain / Q000453:epidemiology*; D005082:Physical Exertion; D011187:Posture; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018582:Sick Leave / Q000706:statistics & numerical data*; D012893:Sleep Wake Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016526:Workload / Q000706:statistics & numerical data; D055815:Young Adult