Incidence and Risk Factors for Soft Tissue Hand and Wrist Conditions in Pregnancy and Postpartum

Abstract

Purpose

This study aimed to identify the incidence of and risk factors associated with soft tissue hand conditions in pregnancy and postpartum. We hypothesized that the incidence of de Quervain tenosynovitis (DQT) and possibly carpal tunnel syndrome (CTS) and trigger finger would be higher in pregnancy and postpartum and that gestational diabetes would be a risk factor for these conditions.

Methods

Using the PearlDiver administrative claims database, we identified pregnant females undergoing vaginal or Cesarean delivery from 2011 to 2022. This cohort was propensity score matched based on age and Elixhauser comorbidity index to females who were not pregnant. We identified pregnant females with a diagnosis of gestational diabetes. Multivariate regression models were used to assess the risk of developing a hand condition within the first year postpartum, adjusting for age, geographical region, insurance plan, comorbidity index, and inflammatory arthritis or diabetes diagnosis. We applied these models to evaluate the risk of developing a hand condition in gestational diabetes patients.

Results

We identified a cohort of 357,534 postpartum patients and 357,803 control patients. We observed a 1.5% incidence of hand conditions postpartum compared to 1.3% in the control population (P < .001). Pregnancy was associated with an increased risk of diagnosis with DQT (odds ratio [OR], 5.11; 95% confidence interval [CI], 4.47–5.85; P < .001). Gestational diabetes was also associated with an increased risk of a hand condition diagnosis (OR, 1.34; 95% CI, 1.26–1.42; P < .001), specifically increased odds of CTS (OR, 1.40; 95% CI, 1.29–1.51; P < .001) and DQT (OR, 1.23; 95% CI, 1.12–1.34; P < .001).

Conclusions

Pregnancy is a significant risk factor for hand conditions and was associated with increased odds of DQT. Gestational diabetes is a significant risk factor for CTS and DQT. Our findings can inform screening and patient education efforts for high-risk pregnant patients.

Type of study/level of evidence

Prognostic IIIb.