Descrição da prevalência e fatores associados às desordens musculoesqueléticas durante a gestação: uma revisão sistemática com metanálise

• Ano de defesa: 2021
• Autor(a) principal: Souza, Bethânia Peloggia de Moraes
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Cidade de São Paulo; Brasil; Pós-Graduação; Programa de Pós-Graduação de Mestrado em Fisioterapia; UNICID
• Palavras-chave em Português: Desordens musculoesqueléticas; Fatores associados; Gestantes; CNPQ::CIENCIAS DA SAUDE::FISIOTERAPIA E TERAPIA OCUPACIONAL
• Link de acesso: https://repositorio.cruzeirodosul.edu.br/handle/123456789/4126

Objective: To develop a systematic review about the prevalence of the main musculoskeletal disorders that occur during pregnancy and factors possibly associated to each musculoskeletal disorder. Methods: A search was performed in May 2019, updated in July 2021, in the PubMed, Embase, CINAHL and SPORTDiscus databases. Observational studies with information on the prevalence and/or associated factors of the main musculoskeletal disorders that occur in habitual-risk pregnant women were included. The risk of bias assessment was performed using an instrument specially adapted for this study. Initially, data were reported and analyzed descriptively. Data were organized according to the study outcome (prevalence or associated factors with musculoskeletal disorder in pregnant women) and separated by musculoskeletal disorder and study design. Prevalence data were pooled in metanalysis according to the musculoskeletal disorder and period of prevalence. Data on associated factors were descriptively analyzed, pooling the most recurrent factors, with statistical significance in two or more studies, for each musculoskeletal disorder. Results: In this systematic review 194 studies were included. Of these, 158 articles contained prevalence data and 116 contained data on associated factors with musculoskeletal disorders, considering that one article could contain more than one outcome of interest. Most of the studies included in the main analyzes of this review (92%) were classified as having moderate and low risk of bias. The most prevalent musculoskeletal disorders during pregnancy were: lumbopelvic pain (738/1000 pregnant women; 95% CI: 655 to 814), low back pain (593/1000 pregnant women; 95% CI: 533 to 650), back pain (560/1000 pregnant women; 95% CI: 438 to 678), stress urinary incontinence (400/1000 pregnant women; 95% CI: 299 to 506), muscle cramp (390/1000 pregnant women; 95% CI: 255 to 558), pelvic girdle pain (347/1000 pregnant women; 95% CI: 164 to 558), and carpal tunnel syndrome (255/1000 pregnant women; 95% CI: 110 to 435). Lumbopelvic pain, low back pain, and stress urinary incontinence showed increased prevalence rates with advanced gestational age. The majority of the metanalyses showed high heterogeneity between studies. Regarding associated factors, multiparity, previous presence of the musculoskeletal disorder and high body mass index were associated with most musculoskeletal disorders related to the spine and pelvis and stress urinary incontinence. Reduction in bone mineral density and carpal tunnel syndrome had unique associated factors, such as the presence of edema and lower body mass index, respectively. Conclusion: Musculoskeletal disorders show a significant prevalence during pregnancy and should not be neglected. Lumbopelvic pain was the most prevalent musculoskeletal disorder in all periods of prevalence. Multiparity was the main associated factor with most musculoskeletal disorders analyzed in this review.