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Acta Obstet Gynecol Scand. 2015 Jun;94(6):622-8. doi: 10.1111/aogs.12613. Epub 2015 Mar 19.

Risk factors for persistent pain and its influence on maternal wellbeing after cesarean section.

Author information

1
Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Obstetrics and Gynecology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
2
Sophiahemmet University, Stockholm, Sweden.
3
Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
4
Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.

Abstract

OBJECTIVES:

To investigate the overall incidence and risk factors for persistent pain and its interference with daily life after cesarean section.

DESIGN:

Prospective long-term follow-up study.

SETTING:

Karolinska University Hospital, Stockholm, Sweden.

POPULATION:

260 healthy women who underwent elective cesarean section.

METHODS:

Information on demographics, medical history, postoperative pain and analgesic requirements was collected. A questionnaire consisting of the Brief Pain Inventory was posted at 3, 6 and 12 months after surgery. Women rated pain intensity as well as interference with factors related to general function and quality of life.

MAIN OUTCOME MEASURES:

The overall incidence and risk factors for persistent postoperative pain at three time points. Persistent pain was considered a secondary outcome.

RESULTS:

At 3, 6 and 12 months respectively 40, 27 and 22% of patients reported pain in one or more locations, in the surgical site as well as in other areas. A psychological indication, as well as a first cesarean section, increased the risk for pain at 3 months. Severe postoperative pain in the immediate postoperative period or undergoing a first cesarean section were significant independent risk factors for the development of persistent pain up to 6 months after cesarean section. Parameters related to quality of life were significantly impaired in women with persistent pain.

CONCLUSION:

Several factors, including severe postoperative pain, were shown to influence the risk for persistent pain after cesarean section. Long-term pain markedly affected women's wellbeing.

KEYWORDS:

Cesarean section; persistent pain; postoperative pain; quality of life; risk factors

PMID:
25714852
DOI:
10.1111/aogs.12613
[Indexed for MEDLINE]

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