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SPINE Volume 32, Number 13, pp 1430–1436
©2007, Lippincott Williams & Wilkins, Inc.
Pelvic Girdle Pain and Lumbar Pain in Relation to
Postpartum Depressive Symptoms
Annelie Gutke, RPT,* Ann Josefsson, MD, PhD,† and Birgitta O
¨berg, PhD*
Study Design. A cohort study.
Objective. To investigate the possible association of
lumbopelvic pain and postpartum depression and differ-
ences in the prevalence of depressive symptoms among
women without lumbopelvic pain and women classified
as having pelvic girdle pain (PGP) and/or lumbar pain.
Summary of Background Data. Lumbopelvic pain and
depression are common pregnancy complications, but
their comorbidity has rarely been evaluated and has not
been studied in relation to subgroups of lumbopelvic
pain.
Methods. In a cohort of consecutively enrolled preg-
nant women, the Edinburgh Postnatal Depression Scale
was used to evaluate depressive symptoms at 3 months
postpartum, applying a primary screening cutoff of ⱖ10
and a cutoff of ⱖ13 for probable depression. Women were
classified into lumbopelvic pain subgroups by means of
mechanical assessment of the lumbar spine, standard
history, pelvic pain provocation tests, a pain drawing, and
the active straight leg raising test.
Results. The postpartum cohort (n ⫽267) comprised
180 (67%) women without lumbopelvic pain, 44 (16%)
with PGP, 29 (11%) with lumbar pain, and 14 (5%) with
combined PGP and lumbar pain. Applying a cutoff of ⱖ10,
postpartum depressive symptoms were more prevalent
in women with lumbopelvic pain (27 of 87, 31%; 95%
confidence interval, 26%–36%) than in women without
lumbopelvic pain (17 of 180, 9%; 95% confidence interval,
5%–13%; P⬍0.001). The comorbidity of lumbopelvic pain
and depressive symptoms was 10%. Depressive symp-
toms were more prevalent in women with lumbar pain
versus women without lumbopelvic pain when applying
cutoffs of ⱖ10 or ⱖ13 (Pⱕ0.002); whereas for women
with PGP, this comparison was significant only at the
screening level of ⱖ10 (P⫽0.01).
Conclusions. Postpartum depressive symptoms were
3 times more prevalent in women having lumbopelvic
pain than in those without. This comorbidity highlights
the need to consider both symptoms in treatment
strategies.
Key words: pelvic girdle pain, lumbar pain, postpar-
tum depressive symptoms, comorbidity, low back pain.
Spine 2007;32:1430 –1436
Depression and low back pain are common complica-
tions of pregnancy. The prevalence of low back pain is
reported to be 45% in pregnant women and 25% in
women postpartum.
1
First onset of depression peaks
during the childbearing years,
2
and approximately 10%
to 20% of women have depressive illness during preg-
nancy or the first year postpartum.
3–5
Postpartum de-
pression has been associated with antenatal risk factors,
such as psychological distress
6
and sick leave due to
pregnancy-related complications.
7
Back pain is an im-
portant pregnancy-related complication worldwide; in
Scandinavian countries, it is the most frequent reason for
sick leave during pregnancy.
8,9
One study reported back
pain to be associated with a twofold increase in the risk
of postpartum depression.
10
However, this estimate was
based on a postal survey; back pain was not identified
and classified using a clinical examination.
Identification of subgroups of low back pain has been
recommended by primary care researcher in order to de-
velop specific treatment strategies.
11
One subgroup of
low back pain, pelvic girdle pain (PGP), is mostly expe-
rienced between the posterior iliac crest and the gluteal
fold, predominantly near the sacroiliac joints and can
radiate to the posterior thigh. Pain can also be experi-
enced in conjunction with, or alone in, the symphysis.
Most women recover from PGP soon after delivery, but
approximately 7% develop serious and persistent pain
with reduced work capacity.
1,12
PGP seems to differ from
lumbar pain with respect to clinical presentation.
1,13
Lumbar pain originates in the lumbar spinal region and
may present with pain radiating down the leg. Lumbar
pain has a more recurrent course.
14
Intervertebral disc
pathology is probably the most common structural
source of nonspecific low back pain.
15,16
There is no
difference in the prevalence of disc abnormalities within
pregnant and nonpregnant populations.
17
The term lum-
bopelvic pain is used where no distinction is made be-
tween PGP and lumbar pain.
1
According to current knowledge and existing guide-
lines,
18,19
clinical evaluation of lumbopelvic pain should
include pelvic pain provocation tests and a neurologic
examination, consider characteristics of lumbar pain as
well as PGP,
20–22
and be sufficient to identify discogenic
pain and red flag conditions.
For evaluation of postpartum depressive symptoms
the Edinburgh Postnatal Depression Scale
23
provides a
From the *Department of Health and Society, Division of Physiother-
apy, and the †Department of Molecular and Clinical Medicine, Divi-
sion of Obstetrics and Gynaecology, Linko¨ ping University, Linko¨ping,
Sweden.
Acknowledgment date: July 10, 2006. First revision date: October 11,
2006. Acceptance date: November 7, 2006.
Supported by grants from the Swedish research council, the Vardal
Foundation, Foundation of the Region Va¨ stra Go¨ taland, Trygg Hansa
Research Foundation, and the Rehabilitation and Medical Research
Foundation.
The manuscript submitted does not contain information about medical
device(s)/drug(s).
Foundation funds were received in support of this work. No benefits in
any form have been or will be received from a commercial party related
directly or indirectly to the subject of this manuscript.
Address correspondence and reprint requests to Annelie Gutke, De-
partment of Health and Society, Division of Physiotherapy, Linko¨ ping
University, SE-581 83 Linko¨ ping, Sweden; E-mail: annelie.gutke@
ihs.liu.se
1430
brief measure of affective morbidity. A primary feature is
its exclusion of items that might reflect physical discom-
fort and thereby confuse depression with the somatic
effects of pregnancy and childbirth.
3
Although the Edin-
burgh Postnatal Depression Scale is not diagnostic, it is a
valid screening measure.
24
High scores do not by them-
selves confirm depressive illness but rather indicate the
need for further assessment.
Since treatment strategies of lumbopelvic pain may be
influenced by possible differences in depressive symp-
toms across subgroups, the development of specific strat-
egies can be strengthened by studying PGP and lumbar
pain concurrently.
The aim of this study was to evaluate whether lum-
bopelvic pain is associated with postpartum depressive
symptoms and if there is a difference in the prevalence of
depressive symptoms among women without lumbopel-
vic pain and women classified as having pelvic girdle pain
and/or lumbar pain.
Materials and Methods
Cohort. The antenatal health care system serves almost 100%
of pregnant women in Sweden (National Board of Health and
Welfare) providing regular physical and psychological health
check-ups during pregnancy and puerperium. The present
study is part of a larger cohort study with baseline evaluation
during early pregnancy. The Regional Research Ethics Com-
mittee approved the study (O
¨414-00). The cohort comprised
all pregnant women consecutively registered at 2 antenatal care
clinics housed in a sociodemographically diverse community of
26,000 people. Swedish-speaking women with an expected
normal pregnancy (as determined by midwives) were ap-
proached for participation between gestational weeks 12 to 18.
The women received written and verbal information about the
study from their midwife before giving oral consent. Women
were excluded if they had a systemic locomotor system disease,
verified diagnosis of spinal problems in the previous 2 months,
or a history of fracture, neoplasm, or previous spinal, pelvic, or
femur surgery.
Assessment. A physical therapist (A.G.) scheduled partici-
pants for assessment by telephone. All women in the cohort
completed one questionnaire at the clinic between gestational
weeks 12 to 18 and one questionnaire 3 months postpartum.
The initial questionnaire comprised background data. The
postpartum questionnaire also included the Edinburgh Postna-
tal Depression Scale and questions about delivery. Women
with any experience of lumbopelvic pain answered questions
about their sick leave due to lumbopelvic pain and whether
lumbopelvic pain had impeded their work during the past 5
years (Table 1).
Measure of Depressive Symptoms. The Edinburgh Postna-
tal Depression Scale is a 10-item self-report scale specifically
Table 1. Descriptive Data for the Women in the Cohort Between Gestational Weeks 12 to 18
Variable Total (n ⫽308)
1: No Lumbopelvic
Pain (n ⫽118)
2: Lumbar Pain
(n ⫽33)
3: Pelvic Girdle
Pain (n ⫽101)
4: Combined Pelvic
Girdle and Lumbar
Pain (n ⫽56)
Group
Comparison* (P)
Age (yr) median (25th,
75th percentile)
29 (26–32) 29 (27–33) 30 (26–32) 28 (26–31) 28 (25–32) NS
Gestational weeks median
(25th, 75th percentile)
15 (14–16) 15 (14–16) 15 (14–16) 15 (14–16) 15 (14–16) NS
Employment full-time
within classification
关n (%)兴
155 (49) 65 (55) 20 (62) 45 (45) 25 (46) NS
Civilian 关n (%) single兴11 (4) 2 (2) 2 (6) 6 (6) 1 (2) NS
Full-/part-time sick leave
at inclusion due to
back pain 关n (%)兴
19 (8) 0 (0) 1 (3) 14 (15) 4 (7) 0.002
1–2: NS
1–3: 0.006
1–4: NS
2–3: NS
2–4: NS
3–4: NS
Lumbopelvic pain
hindered work last 5
yr 关n (%)兴
94 (55) 29 (63) 17 (68) 28 (45) 20 (53) NS
Activity level† last 6 mo
(6 ⫽most active)
关n (%)兴
1–3 210 (68) 78 (67) 26 (79) 68 (67) 38 (68) NS
4–6 97 (32) 39 (33) 7 (21) 33 (33) 18 (32)
Lumbopelvic pain before
1st pregnancy 关n (%)兴
124 (40) 30 (26) 25 (76) 38 (38) 31 (55) ⬍0.001
1–2: ⬍0.001
1–3: NS
1–4: 0.001
2–3: 0.001
2–4: NS
3–4: NS
*Pvalues from Kruskal-Wallis or
2
test. All original 2-tailed Pvalues were multiplied by 6 (Bonferroni correction).
†Activity level 1–3 ⫽manage all household, including gardening and light physical activity; activity level 4 – 6 ⫽the above ⫹exercise at increasing intensity.
NS indicates not significant.
1431Pain and Postpartum Depressive Symptoms •Gutke et al
designed to screen for postpartum depression in community
samples. Each item is scored on a 4-point scale (0–3) with a
total score range of 0 to 30. The scale rates the intensity of
depressive symptoms
25
present within the previous 7 days. Cox
et al proposed a cutoff score of ⱖ10 if the test is to be used for
screening purposes in primary care as in the present study.
23
A
cutoff score of ⱖ13 was recommended for evaluating prob-
able depression. Although the scale cannot confirm a diag-
nosis of depression, when using the threshold of ⱖ10, the
sensitivity for detecting major depression has been reported
to be 100% with a specificity of 82%.
24
Sensitivity of the
Swedish version of the Edinburgh Postnatal Depression Scale
(cutoff score of 11.5) has been reported to be 96% with a
specificity of 49%.
26
Classification of Lumbopelvic Pain. The participants were
classified into 4 groups based on the type of pain experienced:
no lumbopelvic pain, PGP, lumbar pain, and PGP and lumbar
pain (combined pain). Women were determined to have no
lumbopelvic pain if they had no subjective lumbopelvic com-
plaint or fewer than 2 positive pelvic pain provocation tests,
and no lumbar effect from repeated movements, according to
the Mechanical Diagnosis and Therapy (MDT) classification.
27
Assignment to the 3 lumbopelvic pain groups was made fol-
lowing examination by a specialized physiotherapist (A.G.)
who was blinded to the result of the depressive evaluation. The
examination included a standard history focusing on charac-
teristics of lumbar pain
27
and PGP,
1
mechanical assessment of
the lumbar spine based on the MDT protocol, pelvic pain prov-
ocation tests,
13
the active straight leg raising test,
28
neurologic
examination (the straight leg raising test, sensation, and reflex
testing for lower extremities), and a hip rotation range of mo-
tion test. Pain location was indicated by the woman on a pain
drawing. The classification methods are described in a previous
publication.
13
The PGP criteria were 2 or more positive pelvic pain prov-
ocation tests, absence of centralization or peripheralization
phenomena
29
during repeated movement assessment, and no
lumbar effect (i.e., no change in pain and/or change in range of
motion) from repeated movements according to the MDT clas-
sification. The pain onset would be during pregnancy or within
3 weeks after delivery.
20
Lumbar pain was classified based on
change in pain and/or change in range of motion from repeated
movements/different positions of the lumbar spine or based on
experience of centralization and peripheralization phenomena
during examination and less than 2 positive pelvic pain prov-
ocation tests.
Statistics. Logistic regression analysis was used to examine the
association between depressive symptoms, pain classification
group, and possibly confounding descriptive variables. The de-
pendent variable was depressive symptoms with a cutoff score
of ⱖ10. The classifications of lumbopelvic pain were entered as
categorical independent variable (no lumbopelvic pain group
as reference). The covariates were parity (continuous), urine
leakage (yes-no), and body mass index (BMI) (continuous).
The covariates were selected based on the literature and previ-
ous association with both back pain and depression. Selection
was also constrained by the number of possible independent
variables (4 or 5) given the least group of the dependent was
n⫽44.
Statistical analyses were performed using the SPSS program,
11.0 (SPSS Inc., Chicago, IL). The Kruskal-Wallis test was used
for multigroup comparisons of nonparametric data on the or-
dinal level. For nominal data, the
2
test or Fisher exact test
were performed, as appropriate. One-way analysis of variance
was used to analyze continuous parametric data. Multiple
comparisons were controlled using the Bonferroni correction.
Statistical significance was set at alpha level ⫽0.05.
Results
Cohort
A cohort of 457 pregnant women attended the 2 antena-
tal care clinics between August 2001 and September
2003. A total of 308 were included in the study (17%
declined participation, Figure 1; Table 1). Thirty-six
women delivered but were not included in the postpar-
tum analysis; 267 women remained for analysis (Figure
1; Table 2). The 19 women (7%) who declined to par-
ticipate did so due to lack of time, fatigue, or no given
reason. The 36 women excluded from the postpartum
analysis did not differ from the 267 women included in
the analysis regarding age, parity, BMI, urine leakage,
back pain before first pregnancy, and lumbopelvic pain
interference with work or activity level.
Depressive Symptoms and Classification of
Lumbopelvic Pain
After delivery, 87 of 267 women (33%) experienced
some form of lumbopelvic pain: 44 of 267 (17%) PGP,
29 of 267 (11%) lumbar pain, and 14 of 267 (5%) com-
bined pain. Using a cutoff score of ⱖ10, 44 of 267
women (16%) experienced depressive symptoms post-
partum. Of these, 27 women (61%) were classified with
lumbopelvic pain. Thus, 27 of 267 women, 10% of the
cohort, had both lumbopelvic pain and a total score ⱖ10
on the Edinburgh Postnatal Depression Scale. Women
with lumbopelvic pain had higher prevalence of depres-
sive symptoms than those without lumbopelvic pain
(P⬍0.001, Table 3). Twenty-two women (8% of the
cohort) scored ⱖ13 on the Edinburgh Postnatal Depres-
sion Scale (Table 3). The prevalence of depressive symp-
toms was higher among women with lumbar pain com-
pared with women without lumbopelvic pain when
applying a cutoff score of ⱖ10 (P⫽0.002) or ⱖ13 (P⫽
0.001). There was a higher prevalence of depressive
symptoms among women with PGP compared with
women without lumbopelvic pain only when using a cut-
off score of ⱖ10 (P⫽0.01).
The strongest associations were found between de-
pressive symptoms and the 3 classifications of lumbopel-
vic pain. The associations remained significant after ad-
justing for parity, urine leakage, and BMI (odds ratio,
3.58–5.98, Table 4).
Discussion
Postpartum depressive symptoms were 3 times more
prevalent in women with lumbopelvic pain than in those
without, yielding a comorbidity rate of 10% in the co-
hort. Subgroups of women with lumbopelvic pain had a
threefold to sixfold increase in likelihood of screening
positive for depressive symptoms compared with those
1432 Spine •Volume 32 •Number 13 •2007
without lumbopelvic pain. The association between de-
pressive symptoms and lumbopelvic pain could not be ex-
plained by parity, urine leakage, and BMI. Thus, these find-
ings strengthen the probable association between
lumbopelvic pain and postpartum depressive symptoms.
Since the primary aim was to screen for depressive
symptoms, we used a cutoff score of ⱖ10 on the Edin-
burgh Postnatal Depression Scale. In our cohort, the
overall prevalence of depressive symptoms was 16%,
comparable to what has been reported (13%–20%) in
similar studies.
3–5
Because a cutoff score of ⱖ13 is more
commonly used and indicates probable depression, we
applied this for comparison. In studies where this cutoff
score was used, the reported prevalence of depressive symp-
toms in postpartum women varied between 6% and
17%.
4,6,10
The prevalence in our study (8%) is similar to
that reported in other Scandinavian samples (6%–7%).
6,26
The prevalence of depressive symptoms in women
classified as having lumbar pain was determined to be
higher than that in women without lumbopelvic pain
when applying a cutoff score of ⱖ10 or ⱖ13. This was in
contrast to women with PGP, for whom the prevalence
of depressive symptoms was only significantly higher
with the cutoff score of ⱖ10. We can only speculate in
Figure 1. Enrollment of the co-
hort at evaluation in gestational
weeks 12 to 18 and at 3 months
postpartum.
1433Pain and Postpartum Depressive Symptoms •Gutke et al
causes to this difference. The longer experience of lum-
bopelvic pain reported by women with lumbar pain may
partly explain the difference. Women with PGP postpar-
tum might be at risk for depression, especially if their
symptoms become persistent. Furthermore, it has been
shown in primary care that expectations predict long-
term outcome.
30
Women with PGP associate their symp-
toms with pregnancy and expect recovery after delivery
while women with lumbar pain have experience of recur-
rent symptoms that might influence outcome. The small
size of the lumbopelvic pain subgroups may have weak-
ened the power for detecting subgroup differences. How-
ever, both women with PGP and women with lumbar
pain had a significantly higher prevalence of depressive
symptoms as compared with those without lumbopelvic
pain, and this emphasizes the need to consider depressive
symptoms in women with any form of lumbopelvic pain
postpartum.
Few studies have evaluated the comorbidity of post-
partum depression and lumbopelvic pain.
10
In a postal
survey of women 6 to 7 months postpartum, back pain
was associated with a more than twofold greater risk of
depression. Although the reported point prevalence of
probable postpartum depression was higher than in our
study, our result nevertheless confirms the comorbidity
of these common complications of pregnancy.
The prevalence of postpartum lumbopelvic pain in the
present cohort (33%) was similar to that reported (25%)
in a recent review.
1
In our study, women with mild symp-
toms, who nevertheless fulfilled the criteria for PGP
and/or lumbar pain, were classified as having lumbopel-
vic pain. It has been estimated that the prevalence of
lumbopelvic pain in relation to pregnancy increases by
20% when women with mild symptoms are included.
1
The pelvic pain provocation tests are generally used to
identify PGP.
21,31,32
However, using these tests within
the context of a standardized mechanical assessment of
the lumbar spine is of higher diagnostic value.
33
Identi-
fying subgroups of other types of low back pain during
pregnancy such as lumbar pain creates the possibility of
developing and directing specific treatment strategies.
Postpartum depression usually resolves spontane-
ously, but if untreated may persist in up to 25% of
women for 1 year after delivery.
34
Depression has been
reported to have a negative impact on women’s social
adjustment and mother-infant interaction as well as pro-
duce long-term effects such as behavioral problems in the
child.
35
The risk of relapse in a future pregnancy is close
to 50%.
2
In one study, lumbopelvic pain persisted in
20% of women 3 years postpartum.
32
The risk of PGP
relapse in a subsequent pregnancy has been reported to
be 85%.
20
From a preventative perspective, a future
Table 2. Descriptive Data for the Women in the Cohort 3 Months Postpartum
Variable
Total
(n ⫽267)
1: No Lumbopelvic
Pain (n ⫽180)
2: Lumbar Pain
(n ⫽29)
3: Pelvic Girdle
Pain (n ⫽44)
4: Combined Pelvic
Girdle and Lumbar
Pain (n ⫽14)
Group
Comparison* (P)
Parity median (25th,
75th percentile)
2 (1–2) 2 (1–2) 2 (1–3) 2 (1–2) 2 (1–2) NS
Weight of newborn (g)
关mean (SD)兴
3689 (541) 3685 (517) 3780 (459) 3617 (656) 3777 (624) NS
Caesarean delivery
关n (%)兴
22 (8) 12 (7) 2 (7) 5 (11) 3 (21) NS
Breast-feeding 3 mo
postpartum 关n (%)兴
208 (81) 142 (83) 22 (79) 33 (75) 11 (85) NS
Urine leakage 关n (%)兴50 (19) 33 (18) 4 (14) 11 (25) 2 (14) NS
Body mass index (SD) 26 (4) 25 (4) 27 (4) 27 (5) 25 (4) NS
*Pvalues from ANOVA, Kruskal-Wallis, or
2
test. All original 2-tailed Pvalues were multiplied by 6 (Bonferroni correction).
NS indicates not significant.
Table 3. Depressive Symptoms Evaluated 3 Months Postpartum Using the Edinburgh Postnatal Depression Scale
(EPDS) With Cutoff Scores of >10 and >13, Respectively
EPDS
Total Cohort
(n ⫽267)
1: No Lumbopelvic
Pain (n ⫽180)
2⫹3⫹4:
Lumbopelvic
Pain (n ⫽87)
2: Lumbar Pain
(n ⫽29)
3: Pelvic Girdle
Pain (n ⫽44)
4: Combined Pelvic
Girdle and Lumbar
Pain (n ⫽14)
Group
Comparisons* (P)
EPDS ⱖ10
n (%) 44 (16) 17 (9) 27 (31) 11 (38) 12 (27) 4 (29) ⬍0.001
95% CI 12 to 20 5 to 13 26 to 36 20 to 56 14 to 40 5 to 53 1–2: 0.002
1–3: 0.01
1-(2,3,4): ⬍0.001
EPDS ⱖ13
n (%) 22 (8) 7 (4) 15 (17) 8 (28) 5 (11) 2 (14) ⬍0.001
95% CI 5 to 11 1 to 7 9 to 25 12 to 44 2 to 20 5 to 23 1–2: 0.001
1-(2,3,4): ⬍0.001
*Pvalues are from
2
and Fisher exact test (generalized if 4 ⫻2 table). The original significant 2-tailed Pvalues were multiplied by 6 (Bonferroni correction).
1434 Spine •Volume 32 •Number 13 •2007
challenge is to investigate whether pain, depressive
symptoms, or their coexistence predicts persistent or re-
current pain.
In nonpregnant populations, an association has been
found between the persistence of disabling low back pain
and a high level of psychological distress.
36,37
Also, the
persistence of low back pain has been found to be more
common in women.
36
Sleep disturbances due to preg-
nancy and due to childcare during the puerperium com-
pound the risk for depression
10,38
and possibly the risk
of lumbopelvic pain. Disturbed sleep has been shown to
result in increased musculoskeletal pain, tenderness, and
fatigue in healthy people.
39
These reports demonstrate
the vulnerability of women in the childbearing years to
pain and depression.
In primary care, it has been shown that pain and de-
pression predict each other symmetrically,
40
which sug-
gests a possible means of early identification of at-risk
women for either of the symptoms. However, postnatal
depression is commonly overlooked by primary care
teams.
41
Moreover, it has been reported that 25% of
women with morbidity postpartum did not seek help
from health professionals, although 49% would have
liked more help or advice.
42
There are treatment options
for both postpartum PGP and depression.
31,41
Clinical
experiences suggest that treatment strategies target only
one of these pregnancy complications. Based on our find-
ing of high comorbidity of these complications, it seems
important to screen for both depressive symptoms and
lumbopelvic pain at postpartum follow-up or in primary
care in order to identify women at risk and to consider
treatment strategies for both symptoms.
Key Points
●The comorbidity of depressive symptoms (Edin-
burgh Postnatal Depression Scale) and clinically
classified lumbopelvic pain was investigated in a
cohort of women 3 months postpartum.
●Postpartum depressive symptoms were 3 times
more prevalent in women with lumbopelvic pain
than in those without, yielding a comorbidity rate
of 10% in the cohort.
●Subgroups of women with lumbopelvic pain
(pelvic girdle pain, lumbar pain, combined pelvic
girdle and lumbar pain) had a 3- to 6-fold increase
in likelihood of screening positive for depressive
symptoms compared with those without lumbopel-
vic pain.
●Women with lumbar pain had more depressive
symptoms than women without lumbopelvic pain
when applying a cutoff score of ⱖ10 or ⱖ13. This
was in contrast to women with pelvic girdle pain
who only screened positive when applying a cutoff
of ⱖ10.
Acknowledgment
The authors thank Olle Ericsson for statistical advice.
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Table 4. Results From the Logistic Regression
Analyses (Enter Method)
Dependent EPDS With
Cutoff of ⱖ10 df P Odds Ratio 95% CI
Independent variables
No lumbopelvic pain ref 3 0.001 1
Lumbar pain 1 ⬍0.001 5.81 2.16–15.63
Pelvic girdle pain 1 0.008 3.58 1.39–9.22
Combined pain 1 0.009 5.98 1.56–22.97
Parity 1 0.05 1.49 1.00–2.22
Urine leakage 1 0.56 0.74 0.27–2.22
BMI 1 0.70 1.02 0.94–1.11
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1436 Spine •Volume 32 •Number 13 •2007
