Pelvic Girdle Pain in Pregnancy and Postpartum: A Systematic Review and Meta-Analysis

Introduction and Hypothesis Pelvic girdle pain (PGP) is a common musculoskeletal disorder that can substantially affect quality of life during pregnancy and the postpartum period. We aimed to estimate the pooled prevalence of PGP, identify associated factors and summarise commonly used clinical assessment methods. Methods We searched MEDLINE/PubMed, Embase, CINAHL, Emcare, Scopus, and PEDro from inception to 24 July 2026. Methodological quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Random-effects meta-analysis with subgroup and sensitivity analyses were conducted. Heterogeneity was assessed using the I 2 statistic. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results Thirty-two studies ( N = 145,091) were included. The pooled prevalence of PGP was 59% (95% CI 49–68%; I 2 = 97.2%) during pregnancy (predominantly in the third trimester) and 32% (95% CI 19–45%; I 2 = 98.8%) within the first year postpartum. Both estimates showed substantial heterogeneity. Factors associated with postpartum PGP included prior low back pain (OR 1.89; 95% CI 1.43–2.50), antenatal emotional distress (OR 2.11; 95% CI 1.33–3.33) and a positive bilateral posterior pelvic pain provocation (P4) test during the peripartum period (OR 1.72; 95% CI 1.30–2.27). The certainty of evidence was very low for all quantitatively synthesised outcomes. The P4 and active straight leg raise tests were most frequently used assessment methods. Conclusions Pelvic girdle pain was commonly reported during pregnancy and within the first postpartum year. However, given substantial heterogeneity and very low certainty of evidence, findings should be interpreted with caution, thereby limiting generalisability across populations.