Despite an overall global decrease in musculoskeletal disorders in women of childbearing age, many individual countries have seen a rise
Introduction
Women have a phase during their life when they are generally biologically able to have children. During this period of a woman’s life, she is referred to as being of childbearing age, or WCBA for short. The World Health Organization defines WCBA as women between the ages of 15 and 49. During this time, women experience cyclical changes in their sex hormones. These happen over the course of their monthly menstruation cycle (period), and change as they approach the menopause, and around any pregnancies they may have.
Many musculoskeletal disorders are known to affect women more than men, and many start or are diagnosed during a woman’s childbearing years. Understanding this is important for several reasons. Women with musculoskeletal disorders are at high risk of developing pregnancy complications. Many musculoskeletal disorders also increase with age, which could be linked to how women’s hormones change towards the end of their childbearing years.
What did the authors hope to find?
The authors wanted to explore musculoskeletal trends over time in WCBA. They were interested in looking for patterns at global, regional, and national levels over the last 30 years, with a special focus on how musculoskeletal disorders are linked to women’s age or when they were born.
Who was studied?
The study used data for women across the globe. Everyone was aged between 15 and 49 years.
How was the study conducted?
This was a retrospective study using data from the Global Burden of Disease Study. The data were originally collected in 2019, but went back as far as 1990. The authors used this existing database to collect information on how many WCBA also had a musculoskeletal disease, and at what point in their life. The rates were grouped into seven age bands: 15–19, 20–24, 25–29, 30–34, 35–39, 40–44, and 45–49 years. This allowed the authors to see changes in the distribution of musculoskeletal disorders over time.
An age-period-cohort model was also used to estimate the overall annual percentage change in how many WCBA had a musculoskeletal disorder. This is called net drift, and was calculated as a percentage per year. They also worked out something called local drift, within each age group, and looked at the relative risks between women born at different timepoints (different birth cohorts).
What were the main findings of the study?
The main finding was that overall, when looked at globally, there was a trend towards a decline in musculoskeletal disorders in WCBA (net drift). But 138 countries showed a rise, and there were a lot of differences within each age group (local drift).
The authors also found evidence of increasing musculoskeletal disorders in WCBA after adolescence. Although the effects of age were similar regardless of women’s different sociodemographic situations, there were generally lower risks over time for women in higher sociodemographic regions. With successive birth cohorts – that is, women born more recently – there were decreases in the number of WCBA experiencing musculoskeletal disorders.
The authors argue that the rising trend of musculoskeletal disorders in WCBA in more than half of countries worldwide suggests that there are not enough resources invested into the prevention, management, and treatment of these diseases in these countries.
Are these findings new?
Yes. Although several studies have reported before on trends in musculoskeletal disorders in WCBA, they used national data or focused on only one disease. Many countries lack the resources needed to investigate these trends, and until now few studies have been able to explore associations with age, period, and birth cohort from a global view. This new study comprehensively analyses trends over time at global, regional, and national levels from 1990 to 2019. This information could be valuable for understanding the underlying disease dynamics, as well as for health policymaking.
What are the limitations of this study?
Firstly, due to the low medical healthcare levels in some underdeveloped countries, there may be potential misdiagnosis and missed diagnosis for diseases, which would mean the database underestimates the number of musculoskeletal disorders. Secondly, the data relies heavily on statistical modelling methods, which could affect the accuracy of estimates of age, period, and birth cohort effects. Thirdly, it is not possible to explore regional trends within a nation in this dataset, but this could be useful to help recognise areas with different trends and patterns within one country.
What do the authors plan on doing with this information?
The authors hope their study will help highlight trends over time in the prevalence of musculoskeletal disorders in WCBA from multiple perspectives. They are doing more work to identify the year with the most significant changes in trends.
What does this mean for me?
If you are a woman aged between 15 and 49, you have an increased risk of a musculoskeletal disorder as you get older, and throughout your childbearing years. Work is being done to understand the risks and how they change as we age, and depending on other factors such as where we live.
If you have any concerns about your disease or its treatment, you should talk to your doctor or a healthcare professional involved in your care.
Date prepared: June 2024
Summary based on research article published on: February 2024
From: Summary from Cao F, et al. Global, regional and national temporal trends in prevalence for musculoskeletal disorders in women of childbearing age, 1990–2019: an age-period-cohort analysis based on the Global Burden of Disease Study 2019. Ann Rheum Dis 2024;83:121–32. doi:10.1136/ard-2023-224530
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