The Watching Pregnancy Project: LBP occurrence, symptoms and healthcare use from 20-weeks’ gestation until 6-months after birth

Introduction: Many pregnant women experience LBP during pregnancy, which often persists after birth. Those effected have reported frustration that their symptoms are not taken seriously, along with limited availability of treatments to meet their needs. Method: A prospective observational cohort study followed a sample of pregnant women living in the UK, from their routine anomaly scan until six months after birth. An online questionnaire was employed to remotely collect data about LBP history, presentation, treatment and patient reported outcomes at four pre-defined study time- points, two during pregnancy and two after delivery. The study objectives were to test the feasibility of the proposed methods of recruitment and data collection, to describe changes in outcomes and healthcare use at each study time-point. Results: 307 women consented to participate and completed the first questionnaire, with 50% attrition over the course of the study. 121 women completed all four questionnaires. Clinically important changes were observed in quality of life and functional disability with high fear-avoidance beliefs between 31 to 33 weeks’ gestation. Women with a history of LBP were more likely to have symptoms persisting 6-weeks after birth. Over 50% did not receive any treatment for their LBP. A significant proportion opted to self-medicate with painkillers, and many of those receiving physiotherapy for their LBP chose to self-refer. Conclusion: The sole use of remote data collection was a feasible methodology. The deterioration in function and health-related quality of life, along with high fear-avoidance beliefs about physical activity, observed in this study warrant further investigation.