The Relationship between Fear-Avoidance Beliefs and Pain in Pregnant Women with Pelvic Girdle Pain: A Cross-Sectional Study.

This was a cross-sectional survey, so it cannot show that fear-avoidance beliefs cause pelvic girdle pain, or that more severe pain causes higher fear-avoidance scores. Women were recruited from healthcare centers in Tehran and selected by convenience sampling after center selection, so the results may not apply to pregnant women in other settings or with different health-care access. Only women more than 20 weeks pregnant, without underlying disease and without recent intense stressful events were included, so it says little about earlier pregnancy, complex medical cases or recent stress. Fear-avoidance and pain were measured by self-report questionnaires, and the study did not measure depression or anxiety, which the authors list as limitations.

Do not conclude that fear-avoidance beliefs cause pelvic girdle pain or that an intervention targeting fear-avoidance will reduce pain. This was a cross-sectional association, not a trial, and severe pain could also lead to higher fear-avoidance scores.