Association of pain catastrophizing with the incidence and severity of acute and persistent perineal pain after natural childbirth: longitudinal cohort study.
OBJECTIVE
Vaginal birth delivery may result in acute and persistent perineal pain postpartum. This study evaluated the association between catastrophizing, a phenomenon of poor psychological adjustment to pain leading the individual to magnify the painful experience making it more intense, and the incidence and severity of perineal pain and its relationship to perineal trauma.


METHODS
Cohort study conducted with pregnant women in labor. We used the pain catastrophizing scale during hospitalization and assessed the degree of perineal lesion and pain severity in the fi rst 24 hours and after 8 weeks of delivery using a numerical pain scale.


RESULTS
We evaluated 55 women, with acute pain reported by 69.1%, moderate/severe pain by 36.3%, and persistent pain by 14.5%. Catastrophizing mean score was 2.15 } 1.24. Catastrophizing patients showed a 2.90 relative risk (RR) for perineal pain (95% CI: 1.08-7.75) and RR: 1.31 for developing persistent perineal pain (95% CI: 1.05-1.64). They also showed a RR: 2.2 for developing acute and severe perineal pain (95% CI: 1.11-4.33).


CONCLUSIONS
The incidence of acute and persistent perineal pain after vaginal delivery is high. Catastrophizing pregnant women are at increased risk for developing acute and persistent perineal pain, as well as severe pain. Perineal trauma increased the risk of persistent perineal pain.
Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, Brazil.
Anne Danielle Santos
AD
Soares
Tânia Cursino de Menezes
TC
Couceiro
Luciana Cavalcanti
LC
Lima
Fernanda Lobo Lago
FL
Flores
Eusa Maria Belarmino
EM
Alcoforado
Roberto
R
de Oliveira Couceiro Filho
D000208:Acute Disease; D059787:Acute Pain / Q000453:epidemiology*; D000328:Adult; D058443:Catastrophization; D059350:Chronic Pain / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D009321:Natural Childbirth; D010147:Pain Measurement; D010502:Perineum; D012720:Severity of Illness Index