Prevalence of Carpal Tunnel Syndrome During Pregnancy in Iran

Purpose: Carpal tunnel syndrome (CTS) is a common musculoskeletal disorder during pregnancy, second only to back pain. Although the prevalence in the general population is approximately 4%, a prevalence of up to 43% has been reported in pregnant women. This review aimed to assess and summarize reported point-prevalence estimates of CTS among pregnant women in Iran. Methods: Five observational studies conducted in Iran were included. Diagnostic approaches varied across studies. Clinical diagnosis was defined as the presence of characteristic symptoms (paresthesia, numbness, nocturnal symptoms in the median nerve distribution) with or without positive provocative tests (Tinel and/or Phalen). Electrodiagnostic confirmation required abnormal nerve conduction velocity and/or EMG findings consistent with median nerve compression at the wrist. Data were extracted for the entire sample, including trimester, parity, bilateral involvement, and diagnostic tools. Results: A total of 2065 pregnant women were assessed across the included studies. Based on clinical criteria, the estimated prevalence of CTS during pregnancy in Iran was approximately 10.5%. Subjective symptoms were reported in 10.84%, objective signs in 10.31%. Electrodiagnostic tests (EMG and nerve conduction velocity) confirmed CTS in 5.67% of these 2065 pregnant women. Bilateral involvement was observed in 47.7% of symptomatic patients. The highest prevalence was observed in the third trimester (64.4%), and most affected women were experiencing their first pregnancy (55%). Conclusions: Reported prevalence of CTS during pregnancy in Iranian studies varies substantially depending on diagnostic criteria and study design. Although this variability does not indicate systematic underdiagnosis or inconsistent reporting, it highlights methodological heterogeneity across studies. Importantly, there is a paucity of high-quality evidence addressing optimal treatment strategies for CTS during and after pregnancy, underscoring the need for well-designed clinical studies in this area. Type of study/level of evidence: Prognostic III.