We aimed to report the incidence of peripheral nerve decompression surgery during pregnancy and 12 months after delivery in Finland from 1999 to 2017.
Using nationwide data from the Finnish Care Register for Health Care and the Finnish Medical Birth Register, all women of potentially childbearing age (15–49 years) who underwent peripheral nerve decompression surgery or had a pregnancy ending in delivery from January 1, 1999, to December 31, 2017, were included. Incidence rates and incidence rate ratios for operations were calculated for both childbearing women and the age-adjusted general female population.
In total, 308 women underwent carpal tunnel release (CTR) during pregnancy, and an additional 675 women underwent CTR within 12 months after delivery. The incidence of CTR during pregnancy was 38 per 100,000 person-years, with an incidence rate ratio of 0.5 (95% CI, 0.4–0.6), when compared with that in the general population. Women who were active smokers before becoming pregnant were more likely to undergo CTR during pregnancy (odds ratio, 2.4; 95% CI, 1.8–3.0). The highest rates of CTR were observed during the first trimester. The incidence of CTR in the first postpartum year increased steadily during the first 4 months to 79 per 100,000 person-years. During the latter 8 months, incidences were similar to those in the general population (incidence rate ratio, 1.0; 95% CI, 0.9–1.2). Women who smoked were more likely to undergo CTR during the first postpartum year (odds ratio, 1.6; 95% CI, 1.3–1.9).
Carpal tunnel release is performed more rarely during pregnancy than in the age-matched general population. Postpartum incidences increased toward the end of the first year, reaching those observed in the general population after the first 4 months. Smoking before pregnancy is associated with increased incidences of CTR both during pregnancy and the first year after delivery.
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- Peripheral nerve disease in pregnancy.Clin Obstet Gynecol. 2013; 56: 382-388
- Neuromuscular disorders in pregnancy.Handb Clin Neurol. 2020; 172: 201-218
- Carpal tunnel syndrome and meralgia paresthetica in pregnancy.Obstet Gynecol Surv. 2020; 75: 121-126
- Orthopedic issues in pregnancy.Obstet Gynecol Surv. 2008; 63: 103-111
- Systematic review of pregnancy-related carpal tunnel syndrome.Muscle Nerve. 2010; 42: 697-702
- Musculoskeletal considerations in pregnancy.J Bone Joint Surg Am. 1994; 76: 1720-1730
- Carpal tunnel syndrome in pregnancy: frequency, severity, and prognosis.Arch Phys Med Rehabil. 1998; 79: 1285-1287
- Symptoms and neurophysiological picture of carpal tunnel syndrome in pregnancy.Clin Neurophysiol. 2001; 112: 1946-1951
- Prevalence and severity of carpal tunnel syndrome (CTS) during pregnancy.Electromyogr Clin Neurophysiol. 2005; 45: 123-125
- Carpal tunnel syndrome in pregnancy and lactation.J Hand Surg Br. 1990; 15: 93-95
- Carpal tunnel syndrome during pregnancy.Scand J Plast Reconstr Surg Hand Surg. 2006; 40: 41-45
- Peripheral neuropathy in pregnancy.Phys Med Rehabil Clin N Am. 2008; 19: 149-162
- Prospective study of positive factors for improvement of carpal tunnel syndrome in pregnant women.Muscle Nerve. 2007; 36: 778-783
- Predicting surgical intervention in patients presenting with carpal tunnel syndrome in primary care.Clin Epidemiol. 2018; 10: 739-748
- Improved tolerability of open carpal tunnel release under local anaesthetic: a patient satisfaction survey.Arch Orthop Trauma Surg. 2008; 128: 125-127
- What is Findata?.(Accessed December 18, 2022)
- Quality of the Finnish Hospital Discharge Register: a systematic review.Scand J Public Health. 2012; 40: 505-515
- Coverage and accuracy of diagnosis of cruciate ligament injury in the Finnish National Hospital Discharge Register.Injury. 2008; 39: 1373-1376
- Pertrochanteric fracture of the femur in the Finnish National Hospital Discharge Register: validity of procedural coding, external cause for injury and diagnosis.BMC Musculoskelet Disord. 2014; 15: 98
- Data quality after restructuring a national medical registry.Scand J Soc Med. 1995; 23: 75-80
Nordic Centre for Classifications in Health Care. NOMESCO Classification of Surgical Procedures (NCSP), version 1.15. Accessed December 18, 2022. https://norden.diva-portal.org/smash/get/diva2:970547/FULLTEXT01.pdf
- Reproductive health indicators: guidelines for their generation, interpretation and analysis for global monitoring.(Accessed December 18, 2022)
- Guidelines for ethical review in human sciences.(Accessed December 18, 2022)
- The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.Ann Intern Med. 2007; 147: 573-577
- Smoking as risk factor for carpal tunnel syndrome: a birth cohort study.Muscle Nerve. 2019; 60: 299-304
- Incidence of common compressive neuropathies in primary care.J Neurol Neurosurg Psychiatry. 2006; 77: 263-265
- Carpal tunnel release: Lifetime prevalence, annual incidence, and risk factors.Muscle Nerve. 2018; 58: 497-502
- Carpal tunnel syndrome: a review of literature.Cureus. 2020; 12e7333
- Carpal tunnel syndrome in general practice (1987 and 2001): incidence and the role of occupational and non-occupational factors.Br J Gen Pract. 2007; 57: 36-39
- Evaluating the effectiveness of local dexamethasone injection in pregnant women with carpal tunnel syndrome.J Res Med Sci. 2011; 16: 687-690
- Splinting for carpal tunnel syndrome.Cochrane Database Syst Rev. 2012; 2012: CD010003
- Rehabilitation following carpal tunnel release.Cochrane Database Syst Rev. 2016; 2: CD004158
- Determinants of return to work after carpal tunnel release.J Hand Surg Am. 2012; 37: 18-27
- The effect of cigarette smoking on functional recovery following peripheral nerve ischemia/reperfusion injury.Microsurgery. 2011; 31: 59-65
- Associations of cardiovascular risk factors, carotid intima-media thickness and manifest atherosclerotic vascular disease with carpal tunnel syndrome.BMC Musculoskelet Disord. 2011; 12: 80
Published online: March 13, 2023
Accepted: January 4, 2023
Received: July 28, 2022
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