Peripheral joint laxity increases in pregnancy but does not correlate with serum relaxin levels

Schauberger, Charles W.; Rooney, Brenda L.; Goldsmith, Laura T.; Shenton, David; Silva, Paul D.; Schaper, Ana M.

doi:10.1016/s0002-9378(96)70447-7

Cited by 185 publications

(139 citation statements)

References 12 publications

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Section: Occupational Lifting and Fetal-maternal Health Outcomesmentioning

confidence: 99%

“…Many researchers have identified laxity as a contributing factor in pregnancy-related pelvic girdle pain, 27,28 low back pain, 29 and knee pain, 26,[30][31][32][33][34] although direct evidence is lacking. Although the hormonal basis for laxity has been questioned, laxity itself is a wellestablished phenomenon that deserves further attention, especially in relation to short-and long-term maternal health consequences of occupational lifting and other physical job demands.…”

Section: Occupational Lifting and Fetal-maternal Health Outcomesmentioning

confidence: 99%

“…Although the mechanisms underlying laxity are unknown, the condition presents early in pregnancy and persists beyond 6 weeks postpartum. 26 The associated reduction in ligament rigidity is believed to weaken joint stability, increasing demand on stabilizing muscles.Many researchers have identified laxity as a contributing factor in pregnancy-related pelvic girdle pain, 27,28 low back pain, 29 and knee pain, 26,30-34 although direct evidence is lacking. Although the hormonal basis for laxity has been questioned, laxity itself is a wellestablished phenomenon that deserves further attention, especially in relation to short-and long-term maternal health consequences of occupational lifting and other physical job demands.…”

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confidence: 99%

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Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations

MacDonald

Waters

Napolitano

et al. 2013

American Journal of Obstetrics and Gynecology

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Empirically based lifting criteria established by the National Institute for Occupational Safety and Health (NIOSH) to reduce the risk of overexertion injuries in the general US working population were evaluated for application to pregnant workers. This report proposes criteria to guide decisions by medical providers about permissible weights for lifting tasks performed at work over the course of an uncomplicated pregnancy. Our evaluation included an extensive review of the literature linking occupational lifting to maternal and fetal health. Although it has been 29 years since the American Medical Association's Council on Scientific Affairs published its report on the Effects of Pregnancy on Work Performance, these guidelines continue to influence clinical decisions and workplace policies. Provisional clinical guidelines derived from the NIOSH lifting criteria that account for recent evidence for maternal and fetal health are presented and aim to improve the standard of care for pregnant workers. Keywordslifting; occupational hazard; pregnancy; recommendations Clinicians play an important role in decisions concerning work activity restrictions during pregnancy. This role is underscored in the United States where federal regulations for occupational lifting are lacking and limited opportunities for paid antenatal leave are available. 1,2 Findings from a recent survey show that recommendations to pregnant workers in physically demanding jobs vary widely, possibly because of limited clinician training in occupational health 3 and the absence of current authoritative guidelines. 4 The views expressed herein are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health or the official policy or position of the Department of the Army, the Department of the Navy, the Department of Defense, or the United States Government.The authors report no conflict of interest.Reprints not available from the authors. HHS Public AccessAuthor manuscript Am J Obstet Gynecol. Author manuscript; available in PMC 2015 August 28. Author Manuscript Author Manuscript Author Manuscript Author ManuscriptTo address the need for updated empirically based recommendations that can be uniformly applied, this paper presents provisional clinical guidelines for occupational lifting in pregnancy based on an extensive review of the literature linking occupational lifting to maternal and fetal health and application of the National Institute for Occupational Safety and Health (NIOSH) lifting equation. Literature review criteriaAn extensive review of the literature linking occupational lifting to maternal and fetal health was conducted to inform the application of the NIOSH lifting equation to pregnant workers. Using the PubMed MESH Thesaurus terms, pregnancy, lifting, occupational diseases, preeclampsia, hypertension, pregnancy complications, pelvis, sacroiliac joint, pubic symphysis, range of motion articular, joint instability, relaxin, estradiol, biomechanics, stress mechanic...

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Section: Occupational Lifting and Fetal-maternal Health Outcomesmentioning

confidence: 99%

Section: Occupational Lifting and Fetal-maternal Health Outcomesmentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations

MacDonald

Waters

Napolitano

et al. 2013

American Journal of Obstetrics and Gynecology

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“…In samples obtained from parous patients, the thermal transition of collagen was lower in comparison with the samples from nulliparous patients. This finding requires future study and might be correlated with changes in collagen tissue after pregnancy reported by other authors, but not in peritoneal tissue [49][50][51][52][53][54][55][56][57][58][59][60][61].…”

Section: Discussionmentioning

confidence: 85%

“…Collagen type I and III is a structural component of articular ligaments [57,58]. The laxity of ligaments was described to be altered in parous women [59]. Relaxin, estrogen, and progesterone, which have receptors on ligaments and which have increased levels during pregnancy, may influence the status of connective tissue [60,61].…”

Section: Discussionmentioning

confidence: 99%

Stability of peritoneal tissue evaluated by the means of DSC in obese patients undergoing laparoscopic cholecystectomy

Torres

Trębacz

Pietrzyk

et al. 2017

J Therm Anal Calorim

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Obesity is considered to be the leading metabolic disease in the world. The coincidence of postoperative complications is higher in obese individuals; thus, laparoscopic techniques due to their minimally invasive character became a standard in the surgical treatment of obesity. The proper function of peritoneal tissue is essential for the response to surgical trauma. Therefore, understanding the alterations of peritoneal tissue of obese individuals might explain the increased number of postoperative complications observed in obese patients. The study aimed to assess whether the stability of peritoneum is altered in obese patients and whether it corresponds to early postoperative complications in obese patients. Samples of parietal peritoneal tissue were collected at the beginning of the laparoscopic cholecystectomy from 80 patients. Differential scanning calorimetry was performed on samples defrosted at room temperature. Patients were divided into three groups according to the BMI value. For statistical analysis, ANOVA, Chi-square, Student's t test, and correlations with Pearson test were used. Significantly lower DH and higher T m were in patients in whom intraperitoneal adhesions were reported. Lower DH was reported in samples obtained from patients with temperature above 37°C in the first 24 h postoperatively. Enthalpy of thermal transition (DH) in peritoneum obtained from parous was significantly lower in comparison with the samples from nullipara. It can be concluded that DSC parameters correlated with parameters related to the early postoperative period. Occurrence of adhesions was reported more frequently in the group of obese and overweight individuals and correlated with lower change in enthalpy of collagen denaturation.

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The Pregnant Athlete

Mottola¹,

Wolfe²

2000

Women in Sport

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Peripheral joint laxity increases in pregnancy but does not correlate with serum relaxin levels

Cited by 185 publications

References 12 publications

Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations

Clinical guidelines for occupational lifting in pregnancy: evidence summary and provisional recommendations

Stability of peritoneal tissue evaluated by the means of DSC in obese patients undergoing laparoscopic cholecystectomy

The Pregnant Athlete

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