Acta Biomedica Scientia

ASSOCIATION BETWEEN BONE MINERAL DENSITY LOSS DURING PREGNANCY AND PERSISTENT POSTPARTUM BACK PAIN

Dr. Aishwarya D

Pregnancy-related back pain, Bone mineral density (BMD), Ultrasound assessment, Os calcis, Persistent symptoms.

Back pain is a common issue during pregnancy, affecting 20-60% of women. While multiple factors contribute to pregnancy-related back pain, bone mineral density (BMD) loss has been positively associated with its severity. However, the relationship between postpartum BMD recovery and persistent back pain remains unclear. Objective: This study aimed to investigate the correlation between BMD loss during pregnancy and persistent back pain symptoms up to two years postpartum. Methods: A cohort of pregnant women was recruited at Sri Lakshmi Narayana Institute of Medical Sciences & Hospital over a 12-month period. Quantitative ultrasound measurements of BMD were taken at the os calcis in early and late pregnancy, and postpartum at 24-28 months. Women experiencing significant back pain during pregnancy completed pain assessments and were followed up with mailed questionnaires at two years postpartum. Participants with subsequent pregnancies were excluded. Regression analysis was used to evaluate correlations between BMD changes, body composition, and persistent back pain. Results: Among 926 participants, 460 reported significant back pain during pregnancy. At 24-28 months postpartum, 286 women (62%) completed follow-up, with 66 reporting persistent back pain. Women with chronic postpartum back pain exhibited greater BMD loss during pregnancy (p = 0.044) and had higher initial BMD levels in early pregnancy (p = 0.031). At two years postpartum, those with persistent back pain had significantly higher weight gain (p = 0.041) and lower BMD recovery. A positive postnatal BMD balance was protective against persistent pain (p = 0.04). Conclusion: This study demonstrated a significant association between BMD loss during pregnancy and persistent back pain symptoms two years postpartum. Women with higher initial BMD experienced greater losses, which were not fully recovered post-pregnancy, increasing the risk of persistent pain. Future studies should explore BMD recovery across different skeletal sites and its implications for osteoporosis risk and long-term bone health in women