Biopsychosocial factors associated with lumbopelvic pain intensity during pregnancy

Abstract Low back pain (LBP) is the most prevalent musculoskeletal condition and leading cause of disability globally. In pregnant women, pain frequently involves lumbar region and pelvic girdle, so the term pregnancy-related lumbopelvic pain (PLPP) is adopted. Biological, psychological, and social factors influence the development and perception of LBP during pregnancy, recognising multidimensional variables such as kinesiophobia, catastrophising, body surveillance, and functionality appreciation. Unlike previous research, this study jointly examined established biopsychosocial factors and underexplored multidimensional constructs, particularly body surveillance and functionality appreciation, in relation to PLPP intensity. The aim of this study was to evaluate the relationship between the intensity of LBP and variables included in the biopsychosocial model, in addition to the creation of an exploratory model to identify the variables with the greatest relative importance for pain classification. A multicentre cross-sectional observational study was conducted in pregnant women aged over 18 years and in the third trimester, with or without PLPP. Pain intensity was measured and categorised into three levels, and sociodemographic, biological, psychosocial, and multidimensional variables were evaluated. 262 pregnant women were included in the study. The variables of BMI, educational level, anxiety and depression, kinesiophobia, and catastrophising showed significant differences in relation to the pain intensity categories. The exploratory model identified BMI and catastrophising as the variables with the greatest relative importance for pain classification. This analysis of LBP in pregnant women showed significant differences in catastrophising, kinesiophobia, BMI, educational level, anxiety, and depression according to their pain levels.