Are perinatal factors associated with musculoskeletal pain across the lifespan? A systematic review with meta-analysis

Abstract 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, I2 = 0; n = 157) or pre-term birth (OR 0.5, 95% CI 0.0–4.5; I2 = 78%; n = 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.