Psychosocial predictors of persistent postpartum pelvic girdle pain: A systematic review of prospective cohort studies
J Bodyw Mov Ther. 2026 Jul;47:212-218. doi: 10.1016/j.jbmt.2026.04.001. Epub 2026 Apr 3.
ABSTRACT
BACKGROUND: Pelvic Girdle Pain (PGP) persists in a significant subgroup of postpartum women and often leads to long-term disability. Although physical risk factors are well documented, the prognostic value of psychosocial factors remains less clear than in lumbar spine disorders.
OBJECTIVES: To systematically review prospective cohort studies that identify psychosocial predictors of persistent PGP, specifically examining both emotional distress and positive cognitive factors.
METHODS: Major electronic databases were searched for articles published until December 2025. We included prospective cohort studies that measured psychosocial factors during pregnancy or early postpartum and assessed persistent PGP for at least 6 weeks postpartum. Owing to heterogeneity in outcome measures, a best-evidence synthesis was conducted to summarize the direction and strength of the associations.
RESULTS: Emotional distress is a significant predictor of persistent pain. Specifically, the largest prospective cohort study included in the synthesis demonstrated a robust association, with an adjusted odds ratio of 1.5 (95% CI: 1.2-1.9). In the qualitative synthesis, a positive belief in recovery emerged as a robust protective factor (odds ratio: 3.2) in high-quality studies, demonstrating a potentially stronger association than distress measures.
CONCLUSION: Psychosocial factors are potent determinants of the prognosis of PGP. Most notably, positive recovery expectations are not merely the absence of distress but represent a novel and powerful protective factor in their own right. Clinicians should prioritize screening for maladaptive beliefs and recovery expectations, along with emotional distress, to identify women who require targeted biopsychosocial interventions.
PMID:42264795 | DOI:10.1016/j.jbmt.2026.04.001