title: Resolution of pain after childbirth.
abstract: BACKGROUND
  Chronic pain after surgery occurs in 10-40% of individuals, including 5-20% of women after cesarean delivery in previous reports. Pain and depression 2 months after childbirth are independently associated with more severe acute post-delivery pain. Here we examine other predictors of pain at 2 months and determine the incidence of pain at 6 and 12 months after childbirth.
  
  
  METHODS
  Following Institutional Review Board approval, 1228 women were interviewed within 36 h of delivery. Of these, 937 (76%) were successfully contacted by telephone at 2 months, and, if they had pain, at 6 and 12 months after delivery. The primary outcome measure was presence of pain which began at the time of delivery. We also generated a model of severity of acute post-delivery pain and 2 month pain and depression.
  
  
  RESULTS
  Pain which began at the time of delivery was remarkably rare 6 and 12 months later (1.8% and 0.3% [upper 95% confidence limit, 1.2%], respectively). Past history of pain and degree of tissue damage at delivery accounted for 7.0% and 16.7%, respectively, of one aspect in the variability in acute post-delivery pain. Neither of these factors was associated with incidence of pain 2 months later.
  
  
  CONCLUSIONS
  Using a definition of new onset pain from delivery, we show a remarkably low incidence of pain 1 yr after childbirth, including those with surgical delivery. Additionally, degree of tissue trauma and history of chronic pain, risk factors for pain 2 months after other surgery, were unimportant to pain 2 months after cesarean or vaginal delivery.
authors.affiliation: Department of Anesthesiology, Wake Forest School of Medicine, Winston Salem, NC 27157, USA. jimeisenach@gmail.com
authors.forename: James C
authors.initials: JC
authors.lastname: Eisenach
authors.forename: Peter
authors.initials: P
authors.lastname: Pan
authors.forename: Richard M
authors.initials: RM
authors.lastname: Smiley
authors.forename: Patricia
authors.initials: P
authors.lastname: Lavand'homme
authors.forename: Ruth
authors.initials: R
authors.lastname: Landau
authors.forename: Timothy T
authors.initials: TT
authors.lastname: Houle
mesh_terms: D000328:Adult; D002585:Cesarean Section; D015897:Comorbidity; D036861:Delivery, Obstetric; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010146:Pain / Q000453:epidemiology*; D010149:Postoperative Pain / Q000453:epidemiology; D036801:Parturition; D049590:Postpartum Period; D012307:Risk Factors; D012720:Severity of Illness Index