Skeletal, Muscular, and Articular Alterations During Pregnancy: Implications for Maternal Health

• DOI: https://doi.org/10.22533/at.ed.1594722402082

• Palavras-chave: Musculoskeletal pain in pregnancy; Pelvic girdle pain; Relaxin and joint laxity; Prenatal exercise; Postpartum rehabilitation

• Keywords: Musculoskeletal pain in pregnancy; Pelvic girdle pain; Relaxin and joint laxity; Prenatal exercise; Postpartum rehabilitation

• Abstract: RESUME INTRODUCTION Pregnancy induces a myriad of physiological changes in a woman's body to support fetal development. Significant adaptations occur in the musculoskeletal system, driven by hormonal changes and biomechanical stresses. These changes can impact maternal health, necessitating a comprehensive understanding of the skeletal, muscular, and articular alterations that occur during this period. This review focuses on these adaptations, the role of hormones like relaxin, and the management of common musculoskeletal complaints such as pelvic girdle pain and lower back pain. OBJETIVE To examine the skeletal, muscular, and articular changes during pregnancy. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Pregnancy-related musculoskeletal changes” OR “Hormonal influences on musculoskeletal health” OR “Pelvic girdle pain and pregnancy” OR “Non-pharmacological pain management” OR “Postpartum musculoskeletal care” in the last  years. RESULTS AND DISCUSSION Pelvic girdle pain and lower back pain are prevalent among pregnant women, influenced by factors such as hormonal changes and biomechanical adjustments. The hormone relaxin plays a critical role in increasing joint laxity, leading to instability and pain. Weight gain and changes in posture further exacerbate these issues. Effective management includes physical therapy, exercise programs, and supportive devices like maternity belts. Nutritional support and non-pharmacological interventions, such as prenatal yoga and chiropractic care, are also beneficial. The psychological impact of chronic pain is significant, necessitating a holistic approach to pain management. CONCLUSION Pregnancy presents unique challenges to the musculoskeletal system, significantly impacting maternal health. A multidisciplinary approach incorporating physical therapy, tailored exercise programs, nutritional support, and psychological care is essential for managing these changes effectively. Understanding the hormonal and biomechanical influences on musculoskeletal health during pregnancy is crucial for developing comprehensive care plans. Long-term follow-up and postpartum care are necessary to address persistent musculoskeletal issues and ensure the well-being of new mothers. Future research should continue to explore the underlying mechanisms and efficacy of various management strategies to improve outcomes for pregnant women.