Persistent pain after caesarean section and its association with maternal anxiety and socioeconomic background

Daly, B., Young, S., Marla, R., Riddell, L., Junkin, R., Weidenhammer, N., Dolan, J., Kinsella, J. and Zhang, R. (2017) Persistent pain after caesarean section and its association with maternal anxiety and socioeconomic background. International Journal of Obstetric Anesthesia, 29, pp. 57-63. (doi: 10.1016/j.ijoa.2016.10.004) (PMID:27884667)

Abstract

Background: Pain, both from the surgical site, and from other sources such as musculoskeletal backache, can persist after caesarean section. In this study of a predominantly socially deprived population we have sought to prospectively examine the association between antenatal maternal anxiety and socioeconomic background and the development of persistent pain of all sources after caesarean section. Methods: Demographic details and an anxiety questionnaire were completed by 205 women before elective caesarean section. On the first postoperative day, pain scores were recorded, and at four months patients were asked to complete a Brief Pain Inventory and an Edinburgh Postnatal Depression Score. Results: Of 205 parturients recruited, 186 records were complete at the hospital admission phase and 98 (52.7%) were complete at the four-month follow-up phase. At recruitment, 15.1% reported pain. At four months 41.8% (95% CI 32.1 to 51.6%) reported pain, of whom pain was a new finding in 35.7% (95% CI 26.2 to 45.2%). Antenatal anxiety was not a significant predictor of severity of new pain at four months (P=0.43 for state anxiety, P=0.52 for trait anxiety). However, four-month pain severity did correlate with social deprivation (P=0.011), postnatal depression (P<0.001) and pain at 24 h (P=0.018). Conclusion: Persistent pain from a variety of sources after caesarean section is common. Our findings do not support the use of antenatal anxiety scoring to predict persistent pain in this setting, but suggest that persistent pain is influenced by acute pain, postnatal depression and socioeconomic deprivation.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Junkin, Dr Ross and Kinsella, Professor John and Daly, Dr Brenda and Young, Dr Steven
• Authors: Daly, B., Young, S., Marla, R., Riddell, L., Junkin, R., Weidenhammer, N., Dolan, J., Kinsella, J., and Zhang, R.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: International Journal of Obstetric Anesthesia
• Publisher: Elsevier
• ISSN: 0959-289X
• ISSN (Online): 1532-3374
• Published Online: 13 October 2016
• Copyright Holders: Copyright © 2016 Elsevier
• First Published: First published in International Journal of Obstetric Anesthesia 29:57-63
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher