Pain During Pregnancy, is it Chronic and Widespread? A Cross-sectional Study in Galle Sri Lanka

Chronic Widespread Pain (CWP) is defined as “pain reported in at least two sections of two contralateral limbs and in the axial skeleton and has been present for at least three months”. Chronic pains in multiple sites are common during pregnancy. This study was conducted to assess the prevalence and associated factors of CWP among pregnant mothers in the Galle district. A sample of mothers attending randomly selected antenatal clinics from Bope-Poddala Medical Officer of Health area was interviewed by trained data collectors using an interviewer-administered questionnaire and a diagram of the body to locate sites of pain. Data was analysed using descriptive statistics and statistical tests through SPSS version 25, and 0.05 was used as the cut-off p-value for significance testing.  Three hundred mothers (response rate 85.8%) have participated in the study ages ranging from 19 to 43 (median = 28/ IQR = 9). Nearly one-third were in the first pregnancy (35.7%) or having a living child (36.7%) and they were in the second (49.3%) and third (50.7%) trimester. Nearly one-fifth of mothers (20.3%) had complained of pain lasting more than three months, however only 15.3% of mothers met the criteria for CWP. Lower back was the commonest site of pain (48.7%) and around 20% of mothers complained of pain in different sites of lower limbs. The majority (87.3%) were aware of the pain during pregnancy and Public Health Midwives (42.3%) and friends and relatives (35.3%) were the commonest sources of information. While 68.0% of mothers relieved their pain through resting 12.7% have sought treatments from a doctor. CWP was associated with a history of pain (p= 0.002) and better awareness of pain in pregnancy (p=0.02) and was found to be higher in the third trimester (p= 0.07). None of the other factors like age, education level, socioeconomic status, occupation, BMI, parity, or mode of delivery in a previous pregnancy was associated with CWP. Though a higher prevalence of pain in pregnancy was noted, the prevalence of CWP is relatively low. Lower back and lower limbs have been the most common sites of pain during the pregnancy. More attention needs to be paid to pains during the pregnancy as a majority are not seeking medical treatment.