Evaluation of association factors of acute postpartum pain

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Created On: 29/09/2023

This study aimed to examine how labor pain intensity and psychological factors are connected to immediate postpartum pain.

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Key take away

Pre-delivery pain factor along with obstetric complications (like blood loss during delivery, shoulder dystocia) are independently linked with high acute postpartum pain.

Background

This study aimed to examine how labor pain intensity and psychological factors are connected to immediate postpartum pain.

Method

The study involved women with singleton pregnancy classified as having American Society of Anesthesiologists (ASA) physical status II, who were at 36 or more weeks of gestation. The primary focus was on understanding the connection between labor pain intensity and the experience of severe immediate postpartum pain within the first 24 hours after delivery (measured on numeric rating scale (NRS) where scores ≥ 3 out of 10 indicated high pain levels).

Prior to delivery, participants completed questionnaires that included the Angle Labor Pain Questionnaire (A-LPQ), the Pain Catastrophizing Scale (PCS), the Fear Avoidance Components Scale (FACS), and the State Trait Anxiety Inventory (STAI). In addition, various demographic, pain-related, obstetric, and neonatal characteristics were recorded.

Result

Out of the 880 women under study, 121 (13.8%) reported experiencing high levels of immediate postpartum pain within the first 24 hours after delivery. Notably, scores from the A-LPQ, PCS, FACS, and STAI questionnaires were not considerably linked to the occurrence of immediate postpartum pain.

However, specific aspects of the A-LPQ related to pain during childbirth (adjusted odds ratio [aOR] 1.03), raised blood loss during delivery (for every 10 ml change; aOR 1.01), instances of shoulder dystocia (aOR 10.06), and the use of pethidine for labor pain relief (aOR 1.74) were all independently associated with a higher likelihood of experiencing immediate postpartum pain.

Furthermore, a history of experiencing occasional nausea during menstruation prior to the current pregnancy (aOR 0.34) was found to be independently linked with a minimized risk of experiencing high levels of immediate postpartum pain.

Conclusion

Labor pain intensity as assessed via A-LPQ total score was not linked with acute postpartum pain. Pre-existing pain factors prior to delivery, along with complications arising during childbirth were identified as independently correlated with the likelihood of experiencing severe immediate postpartum pain.