This study was conducted to objectify the severity of signs and symptoms related to LPP during the third quartile of uncomplicated pregnancy. At the time of measurement, 60.4% of the study population reported pain in the lower back or pelvis at that moment or during the previous seven days. Severity of pain and disability were mild in most pregnant women and severe in about 20% of the women with LPP, i.e. in about 12% of all pregnant women. A strength of the current study is the multi-dimensional approach applied to a single study, including clinical tests which are also assessed in subjects without LPP. A GSI-IX drawback of the multi-dimensional

approach is that blinding of the investigators, as explained in the methods section, was not possible. A second limitation of the study is that, although both assessors practiced the entire physical examination together several times and

wrote a standardized protocol to be followed during examinations, the reliability between assessors was not tested. The prevalence of LPP in the present study is similar to that found in earlier studies (Wu et al., 2004). The prevalence of LPP in this pregnant population (60.4%) is much higher than in studies performed in non-pregnant general populations. Hoy et al. (2010) reviewed eight studies that measured the one-week prevalence of LBP in a general population and found a median prevalence of 11.5% (range 6.3–20.1%). The associations between current LPP and the number of previous pregnancies, BMI and previous LPP (pregnancy-related or not) are consistent with most earlier studies Ibrutinib solubility dmso (Wu et al., 2004 and Bjelland et al., 2010). The frequency of reported UI was higher in LPP than in controls without LPP. However, the severity of UI was not related to LPP (Table 1). The present study provides no support for any explanation regarding the association between the existence of UI and

LPP. Earlier studies suggested that both UI and LPP are caused by improper functioning of the pelvic floor and/or trunk muscles (Pool-Goudzwaard et al., 2004, Pool-Goudzwaard Lepirudin et al., 2005 and Smith et al., 2008). In the present study there was no difference in fatigue score between women with and without LPP. Since high scores for fatigue are associated with various painful disorders (Lwin et al., 2003, Avalos et al., 2007 and Van Emmerik et al., 2010), this result was unexpected. The lack of association between LPP and fatigue during pregnancy can probably be attributed to the relatively short duration of pain in many cases. In the present study, the relatively high level of fatigue in women with and without LPP is probably caused by the pregnancy (Table 1). The reported sites of pain in the present study are similar to earlier reports (Table 2) (Albert et al., 2000 and Robinson et al., 2010).