妊娠和产后手和腕部软组织疾病的发生率和危险因素

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-07-24 DOI:10.1016/j.jhsg.2025.100778

Gabriella B. Smith BA , Bill Young BA , Ashley L. Titan MD , Deborah E. Kenney MS, OTR/L , Amy L. Ladd MD

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引用次数: 0

摘要

目的探讨妊娠期及产后手部软组织疾病的发生率及相关危险因素。我们推测，妊娠期和产后的de Quervain腱鞘炎（DQT）、腕管综合征（CTS）和扳机指的发病率会更高，而妊娠期糖尿病可能是这些疾病的危险因素。方法使用PearlDiver行政索赔数据库，对2011年至2022年接受阴道或剖宫产分娩的孕妇进行调查。该队列根据年龄和Elixhauser合并症指数对未怀孕的女性进行倾向评分匹配。我们确定了诊断为妊娠糖尿病的怀孕女性。采用多变量回归模型评估产后一年内发生手部疾病的风险，调整年龄、地理区域、保险计划、合并症指数、炎症性关节炎或糖尿病诊断。我们应用这些模型来评估妊娠期糖尿病患者发生手部疾病的风险。结果共纳入357,534名产后患者和357,803名对照患者。我们观察到产后手部疾病的发生率为1.5%，而对照组为1.3% (P <；措施)。妊娠与诊断为DQT的风险增加相关(优势比[OR]， 5.11；95%置信区间[CI]， 4.47-5.85；P & lt;措施)。妊娠期糖尿病也与手部疾病诊断的风险增加相关(OR, 1.34；95% ci, 1.26-1.42；P & lt;.001)，特别增加了CTS的几率(OR, 1.40；95% ci, 1.29-1.51；P & lt;.001)和DQT (OR, 1.23；95% ci, 1.12-1.34；P & lt;措施)。结论妊娠是手部疾病的重要危险因素，与DQT发生率增高有关。妊娠期糖尿病是CTS和DQT的重要危险因素。我们的发现可以为高危孕妇的筛查和患者教育工作提供信息。研究类型/证据水平预后

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

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.