The effects of physical activity throughout pregnancy on maternal lumbopelvic musculoskeletal health
Researchers followed women during pregnancy and early postpartum to explore how physical activity relates to common musculoskeletal conditions, including urinary incontinence, pelvic organ prolapse, and lumbopelvic pain.
Objectives: To investigate associations between physical activity volume during pregnancy and early postpartum with musculoskeletal conditions, specifically urinary incontinence, pelvic organ prolapse, and lumbopelvic pain.
Design: Prospective cohort study. Methods: Data from the Queensland Family Cohort study (2018–2021) were analysed. Physical activity at 24- and 36-weeks' gestation, and 6 weeks postpartum was reported using a modified Active Australia Survey. Participants were categorised into nil to low (0–<500 metabolic equivalent of task [MET]·min/week), moderate (500–<1000 MET·min/week), or high (≥1000 MET·min/week) volumes. Symptoms of urinary incontinence, pelvic organ prolapse, and lumbopelvic pain were collected at corresponding timepoints. Associations between physical activity volume and musculoskeletal outcomes were examined using generalised estimating equations, adjusting for maternal age, pre-pregnancy weight, parity, and delivery mode.
Results: Nil to low physical activity was associated with greater pelvic organ prolapse severity (p = 0.002), but not with urinary incontinence or lumbopelvic pain. Gestational period was the strongest predictor of symptom severity across all outcomes (p < 0.001), peaking at 36-weeks' gestation and decreasing by 6 weeks postpartum. Parity and pre-pregnancy weight were predictors of urinary incontinence and lumbopelvic pain (p < 0.001), maternal age for urinary incontinence (p= 0.021), and delivery mode for urinary incontinence and pelvic organ prolapse (p < 0.001).
Conclusions: Physical activity volume was not significantly associated with urinary incontinence or lumbopelvic pain; however, nil to low physical activity was associated with increased pelvic organ prolapse symptom severity. Moderate physical activity during pregnancy may support optimal lumbopelvic musculoskeletal health. © 2025 The Author(s). Published by Elsevier Ltd on behalf of Sports Medicine Australia
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