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Prevalence and Predictors of Chronic Pain in Childbirth
Abstract Number: O1-01
Abstract Type: Original Research
Introduction: A significant number of women experience chronic pain following childbirth. Ten percent of women report persistent pain two months after vaginal delivery and up to 18.6% after cesarean delivery.1,2 However, previous studies have not evaluated whether postpartum pain predated the delivery or even the pregnancy. The objective of this study was to identify the incidence of pain and evaluate if pre-existing pain, pain during pregnancy or pain present two weeks after delivery are associated pain occurring three months postpartum.
Methods: With institutional ethics board approval and written informed consent, primiparous women at 30-36 weeks gestational age with an uncomplicated singleton pregnancy were recruited from a large urban perinatal clinic. Participants completed questionnaires on socio-demographics and generalized pain using the McGill Pain Questionnaire. The location of pain was noted and pain intensity was quantified using a numeric rating scale. The first of three questionnaires was completed in the perinatal clinic. Questionnaires 2 & 3 were completed electronically two weeks and three months postpartum.
Results: Of the 254 women who consented to participate, 134 women completed all three surveys and were included in the analysis. Fifty patients (37.3%) had a chronic pain condition or experienced pain prior to pregnancy, while 74 patients (55.2%) described pain in the prior four weeks of their pregnancy. Following delivery, pain was persistent in 58/134 patients (43.3%) two weeks postpartum and in 34/134 patients (25.4%) three months postpartum. Of the patients that reported no pain prior or in pregnancy, 12/41 (29.3%) patients described pain two weeks postpartum and 12/41 (29.3%) three months postpartum. Patients with pre-existing pain were more likely to experience pain two weeks postpartum (p=0.009) and patients with pain two weeks postpartum were more likely to have pain three months postpartum (p=0.004).
Discussion: The percentage of women with chronic pain after delivery is greater than previous studies have indicated. In our study, women with pain two weeks postpartum were significantly more likely to have pain at three months. Further investigation is required to determine whether pre-existing pain, pain in pregnancy or pain at two weeks postpartum can adequately predict the likelihood of chronic pain.
1. Anesthesiology 2013;118:143-51.
2. Acta Anaesthesiol Scand. 2004;48:111-6.