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J Obstet Gynaecol Can. 2017 Sep;39(9):734-741. doi: 10.1016/j.jogc.2017.01.026. Epub 2017 Jun 16.

Prevalence and Predictors of Chronic Pain in Pregnancy and Postpartum.

Author information

1
Department of Women's & Obstetric Anesthesia, IWK Health Centre, Halifax, NS; Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS. Electronic address: ammunro@dal.ca.
2
Department of Women's & Obstetric Anesthesia, IWK Health Centre, Halifax, NS; Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS.
3
Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS; Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS; Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS.
4
School of Nursing, Dalhousie University, Halifax, NS; Department of Obstetrics and Gynecology, IWK Health Centre, Halifax, NS.
5
Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS; Department of Obstetrics and Gynecology, IWK Health Centre, Halifax, NS.

Abstract

OBJECTIVE:

A clinically relevant number of patients report pain 1 year after vaginal delivery or Caesarean delivery. Study objectives were to identify the incidence of peripartum pain; determine whether pre-existing pain, pregnancy pain, or pain 2 weeks postpartum predicts pain at 3 months; and to identify whether delivery mode, epidural analgesia use, or delivery complications predict non-genito-pelvic pain postpartum.

METHODS:

Primiparous women at 30 to 36 weeks GA with an uncomplicated singleton pregnancy were recruited from a large perinatal clinic. Participants completed questionnaires on sociodemographics and non-genito-pelvic pain. Questionnaires were completed in the perinatal clinic and then electronically 2 weeks and 3 months postpartum.

RESULTS:

Of the 133 women included, 50 patients (38%) had a chronic pain condition or pain prior to pregnancy, whereas 73 patients (55%) reported pain in pregnancy. Pain was present 2 weeks postpartum in 57 patients (43%) and 3 months postpartum in 33 patients (25%). Patients with pre-existing pain were more likely to experience pain 2 weeks postpartum (P = 0.006), and patients with pain 2 weeks postpartum were more likely to have pain 3 months postpartum (P = 0.005). Women who had a Caesarean delivery (P < 0.001) were more likely to have non-genito-pelvic pain at 2 weeks but not 3 months postpartum.

CONCLUSIONS:

Women with pain 2 weeks postpartum were significantly more likely to have pain at 3 months. Further investigation is required to determine whether pre-existing pain, pain in pregnancy, or pain at 2 weeks postpartum can adequately predict the likelihood of chronic pain.

KEYWORDS:

Chronic pain; postpartum; pregnancy

PMID:
28624445
DOI:
10.1016/j.jogc.2017.01.026

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