ArticleBMC anesthesiology2026
Understanding maternal pain and psychological vulnerabilities associated with the development of sub-acute pain after childbirth.
Article in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03167905 (Comparison of the Role of Epidural Analgesia Versus Non-epidural Analgesia in Postnatal Depression and Persistent Pain Development), which is not on this map. Not yet cited in PubMed.
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Comparison of the Role of Epidural Analgesia Versus Non-epidural Analgesia in Postnatal Depression and Persistent Pain Development: a Randomized Controlled Trial
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5 authors.
Funding
Abstract
backgroundCurrent research primarily concentrates on acute and chronic postpartum pain, while sub-acute pain after childbirth (SAPC) remains a significant but often under-recognized health concern. We determined if pain and psychological vulnerabilities, obstetric factors, and analgesic choices were associated with the development of SAPC.
methodsWe included women with singleton pregnancy. Pain and psychological vulnerabilities were assessed using validated questionnaires (Angle Labor Pain Questionnaire (A-LPQ), Central Sensitization Inventory (CSI), Edinburgh Postnatal Depression Scale (EDPS), Fear Avoidance Components Scale (FACS), Pain Catastrophizing Scale (PCS), Perceived Stress Scale (PSS), State Trait Anxiety Inventory (STAI)). The primary outcome of SAPC, defined as having postpartum pain lasting for ≥4 weeks, was followed up at 6 to 10 weeks postpartum with online survey.
resultsOf the 881 patients recruited, 816 completed the postpartum follow-up, with 99 (12.1%) patients having developed SAPC. Having higher CSI score (adjusted odds ratio (aOR) 1.03, 95%CI 1.01-1.04), increased number of pain relief administrations (aOR 1.55, 95%CI 1.23-1.95), use of artificial rupture of membrane and oxytocic for labor induction (aOR 2.72, 95%CI 1.51-4.91), greater volume of blood loss during delivery (every 10-mL increase; aOR 1.02, 95%CI 1.01-1.03), having had third-degree tear during delivery (aOR 4.12, 95%CI 1.28-13.27) and greater infant weight (aOR 1.15, 95%CI 1.02-1.30) were independently associated with greater risk of SAPC. The use of prostin for labor induction was protective against the risk of SAPC (aOR 0.56, 95%CI 0.34-0.93) (Area under the curve (AUC) = 0.73).
conclusionOur center's multivariable model demonstrates moderate predictive performance and may inform the future development and refinement of predictive tools to identify patients at increased risk of SAPC, thereby supporting more timely monitoring and early interventions for postpartum pain management.
trial registrationThis study was registered on clinicaltrials.gov registry (NCT03167905) on 30/05/2017.
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