Roach Megan H, Nelson D Alan, Koreerat Christina M, Foglia Lisa M, Mauntel Timothy C
Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, VA.
Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD.
J Athl Train. 2025 Mar 1;60(3):245-251. doi: 10.4085/1062-6050-0414.24.
Noncombat musculoskeletal conditions (MSKs) are endemic among service members and disproportionately affect females. Pregnancy and childbirth contribute to lower physical fitness assessment scores and higher body mass index, both risk factors for MSKs, for up to 1 year postpregnancy. However, there is a paucity of information regarding the impact of pregnancy on MSKs.
To explore the association between the postpregnancy period and incident MSKs.
Retrospective, longitudinal cohort study.
Medical and administrative data from the Medical Assessment and Readiness System.
Female military service members with and without a pregnancy.
MAIN OUTCOME MEASURE(S): Months since pregnancy end, health history, and demographic and military service data were abstracted for each individual. Subsequent MSKs were identified with relevant International Classification of Diseases-10 codes. A multivariable logistic regression model assessed the association between the time since pregnancy end and MSK incidence.
A total of 298 607 female service members were identified, of which 19 980 had a pregnancy. A larger percentage of postpregnancy service members (65.8%) had an MSK diagnosis than the nonpregnant cohort (60.3%). Adjusting for covariates, the model suggests a temporal influence on postpregnancy MSK incidence, such that service members 3 to 4 months and 5 to 6 months postpregnancy were more likely to be diagnosed with an MSK than the nonpregnant cohort. However, service members <2 months postpregnancy were less likely to be diagnosed with an MSK, and the odds of an MSK beyond 6 months decreased out to 24 months postpregnancy.
Pregnancy may increase a service member's odds of sustaining an MSK 3 to 6 months postpregnancy. Understanding the relationships between pregnancy and MSK risks may lead to changes in postpartum return-to-duty/activity policies, better enabling service members to care for themselves and their families.
非战斗性肌肉骨骼疾病（MSK）在军人中很常见，且对女性的影响尤为严重。怀孕和分娩会导致体能评估分数降低和体重指数升高，这两个因素都是MSK的风险因素，在产后长达1年的时间里都会存在。然而，关于怀孕对MSK影响的信息却很少。
探讨产后时期与新发MSK之间的关联。
回顾性纵向队列研究。
医疗评估与准备系统的医疗和行政数据。
有怀孕和无怀孕的女性军人。
为每位个体提取自怀孕结束后的月数、健康史以及人口统计学和军事服役数据。随后通过相关的国际疾病分类第10版代码确定后续的MSK。一个多变量逻辑回归模型评估了自怀孕结束后的时间与MSK发病率之间的关联。
共识别出298607名女性军人，其中19980人怀孕。与未怀孕队列（60.3%）相比，产后军人中被诊断患有MSK的比例更高（65.8%）。在对协变量进行调整后，该模型表明对产后MSK发病率存在时间影响，即产后3至4个月和5至6个月的军人比未怀孕队列更有可能被诊断患有MSK。然而，产后不到2个月的军人被诊断患有MSK的可能性较小，并且在产后6个月至24个月期间，MSK的发病几率会降低。
怀孕可能会增加军人在产后3至6个月患MSK的几率。了解怀孕与MSK风险之间的关系可能会导致产后重返岗位/活动政策的改变，从而更好地使军人能够照顾自己和家人。
