Association Between Pregnancy and Musculoskeletal Conditions in Active-Duty Military Service Members

Context: 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. Objective: To explore the association between the postpregnancy period and incident MSKs. Design: Retrospective, longitudinal cohort study. Setting: Medical and administrative data from the Medical Assessment and Readiness System. Patients or Other Participants: 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. Results: 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. Conclusions: 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.