Epidemiology of de Quervain`s Tenosynovitis in Post-partum Women

Objective:
de Quervain’s disease (DQD) is caused by stenosis of the first dorsal compartment containing the abductor pollicis longus and extensor pollicis brevis. As noted by de Quervain himself in the end of the 19th century, this condition effects women six times more than men and is also common in pregnant and lactating women. A more recent large epidemiological investigation reported a female to male ratio of 4.6/1. DQD in pregnant and lactating women is known to be self-limited and several studies have shown this condition resolves after cessation of lactation. The epidemiology and natural history of DQD in pregnant and lactating women is described for small patient groups only. In this study we sought to describe the gestational risk factors associated with post-partum DQD.

Method:
Sixty-three post-partum women with DQD were included in this study. Medical records were reviewed for patient characteristics including age, hand dominance, co-morbidities and BMI and gestational information including length of pregnancy, gestation number, single or twins birth and weight at birth. Odds ratio (OR) to incur de Quervain`s tenosynovitis were calculated with the control group of 630 post-partum women without DQD who gave birth between 2012-2020 in the same district.

Results:
Length of pregnancy (>40 weeks, OR=5.81 (3.29- 10.28), first childbirth (OR=2.23 (1.32-3.77)), Overweight (BMI>25, OR=2.08 (1.14-3.81)) were all associated with a statistically significant risk of developing DQD. Number of fetuses>1 (OR=0.98 (0.29-3.33)) and birth weight over 3.5 kg (OR=0.60(0.30-1.21)) were not associated with higher risk of DQD.

Conclusion:
Gestational risk factor to develop post-partum DQD were first pregnancy and long pregnancy of over 40 weeks. Interestingly, child’s birthweight and number of fetuses, both factors that might increase load on the first dorsal compartment while holding the child, were not shown to increase the risk of post-partum DQD.