RESUMO
BACKGROUND: Musculoskeletal conditions are common health issues with great impact on individuals. Although many factors have been associated with the development of musculoskeletal pain, such as perinatal factors, its aetiology is still poorly understood. OBJECTIVE: To systematically investigate whether perinatal factors can increase the risk of having musculoskeletal pain across the lifespan. METHODS: MEDLINE, CINAHL, Scopus, Web of Science and EMBASE databases were searched from their inception to December 2017. Descriptors used in our search strategy were related to "perinatal factors" and "musculoskeletal pain". There were no language, age, sex or date restrictions. Meta-analysis was used to pool the estimates of association between perinatal factors and musculoskeletal pain. RESULTS: Among the six articles included in this systematic review, three were extracted for the meta-analysis. The pooled of three and two studies showed no association between chronic musculoskeletal pain and low birth weight (OR 1.8, 95% CI 0.9-3.8, I2â¯=â¯0; nâ¯=â¯157) or pre-term birth (OR 0.5, 95% CI 0.0-4.5; I2â¯=â¯78%; nâ¯=â¯374) in adults, respectively. Overall, the quality of evidence after applying the GRADE approach was very low across all the studies. CONCLUSION: In adults, our meta-analysis showed no association between birth weight or pre-term birth and musculoskeletal pain, and the quality of the evidence was very low. Thus, the very low quality of evidence and limited number of studies do not suggest a direct clear association. Further high-quality longitudinal studies accounting for more relevant confounders are needed to better understand the complex mechanism that may operate between perinatal factors and musculoskeletal pain.
Assuntos
Doenças Musculoesqueléticas/epidemiologia , Dor Musculoesquelética/epidemiologia , Obesidade/epidemiologia , Complicações na Gravidez/epidemiologia , Adulto , Índice de Massa Corporal , Causalidade , Dor Crônica/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , GravidezRESUMO
PURPOSE: To investigate associations between anthropometric measures (birthweight, weight gain and current BMI) and back pain; and to determine whether these associations differ between those born with low or full birthweight. METHODS: The cross-sectional associations between the lifetime prevalence of back pain and anthropometric measures (birthweight, weight gain and current BMI) among 2754 adult twins were investigated in three stages: total sample; within-pair case-control for monozygotic and dizygotic twins together; and within-pair case-control analysis separated by dizygotic and monozygotic. Results were expressed as odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Birthweight was not associated with back pain (OR 0.99; 95% CI 0.99-1.00), but a weak association was found between weight gain (OR 1.01; CI 1.00-1.01) or current BMI (OR 1.02; 95% CI 1.00-1.05) and back pain in the total sample analysis. These associations did not remain significant after adjusting for genetics. The associations did not differ between those whose were born with low or full birthweight. CONCLUSION: Birthweight was not associated with prevalence of back pain in adulthood. Weight gain and current BMI were weakly associated with back pain prevalence in the total sample analysis but did not differ between those born with low or full birthweight. However, the small-magnitude association only just achieved significance and appeared to be confounded by genetics and the early shared environment. Our results suggest that a direct link between these predictors and back pain in adults is unlikely. These slides can be retrieved under Electronic Supplementary Material.