Department of Surgery, Central Finland Hospital Nova, Jyväskylä, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland; School of Medicine, University of Eastern Finland, Kuopio, Finland.
J Hand Surg Am. 2023 May;48(5):452-459. doi: 10.1016/j.jhsa.2023.01.013. Epub 2023 Mar 13.
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.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.
本研究旨在报告 1999 年至 2017 年芬兰妊娠期和产后 12 个月行外周神经减压手术的发生率。
利用来自芬兰医疗保健护理登记系统和芬兰医疗出生登记系统的全国性数据，纳入所有有生育能力的年龄（15-49 岁）的女性，这些女性于 1999 年 1 月 1 日至 2017 年 12 月 31 日期间行外周神经减压手术或分娩结束妊娠。对分娩女性和年龄调整后的普通女性人群的手术发生率和发生率比值进行了计算。
共有 308 名女性在妊娠期间行腕管松解术（CTR），另有 675 名女性在产后 12 个月内行 CTR。妊娠期间 CTR 的发生率为 38/100000 人年，与普通人群相比，发生率比值为 0.5（95%CI，0.4-0.6）。在妊娠前为主动吸烟者的女性更有可能在妊娠期间行 CTR（比值比，2.4；95%CI，1.8-3.0）。CTR 的最高发生率发生在妊娠早期。产后第一年的 CTR 发生率在头 4 个月逐渐增加至 79/100000 人年，此后 8 个月与普通人群相似（发生率比值，1.0；95%CI，0.9-1.2）。吸烟的女性更有可能在产后第一年行 CTR（比值比，1.6；95%CI，1.3-1.9）。
妊娠期间行 CTR 的频率低于年龄匹配的普通人群。产后发生率在第一年接近结束时增加，在头 4 个月后达到普通人群的水平。妊娠前吸烟与妊娠期间和产后第一年 CTR 发生率增加有关。
研究类型/证据水平：预后 II 级。
