Low back pain during pregnancy: Prevalence, risk factors and association with daily activities among pregnant women in urban Blantyre, Malawi

Introduction
Low back pain (LBP) is a significant musculoskeletal problem during pregnancy with potential to negatively affect the woman’s quality of life. Data on LBP among pregnant women in Malawi is almost non-existent. We investigated the prevalence and risk factors of LBP and its association with functional activities in pregnant women in Malawi.
Methods
We conducted a cross-sectional study in Blantyre, Malawi, from December 2017 to January 2018. Participants were drawn from low-risk antenatal clinics in selected local health facilities. Written informed consent was sourced from study participants, permission was granted at each study site and the study received ethics approval from the College of Medicine Research Ethics Committee (COMREC). Descriptive statistics were used to summarize the data. Categorical variables were summarized as frequencies and percentages. The association between occurrence of LBP and selected factors was assessed using the Chi-Square test (X²) (α=5%) followed by a multiple logistic regression. Odds ratios (OR) and their 95% confidence intervals were calculated.
Results
We interviewed 404 pregnant women; the mean age of respondents was 25.83 years old (SD: ±5.91). Prevalence of LBP in pregnancy was 62% (n=249); 172 (69%) of these reported LBP for the first time during the current pregnancy. Gestational age was significantly associated with presence of LBP (P= 0.03). LBP was associated with the women’s sleep patterns, mobility, lifting techniques and sexual activities. However, a reasonable high proportion of those with LBP (34%) did not seek care for their low back pain.
Conclusion
LBP is highly prevalent and an important clinical condition among pregnant women in Blantyre, Malawi. Given the significant effect of LBP on quality of life, health workers need to be proactive in identifying LBP and provide the appropriate management.