title: Association of pain catastrophizing with the incidence and severity of acute and persistent perineal pain after natural childbirth: longitudinal cohort study.
abstract: 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 first 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.
authors.affiliation: Anesthesiologist, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Recife, PE, Brazil.
authors.forename: Anne Danielle Santos
authors.initials: AD
authors.lastname: Soares
authors.affiliation: Holder of Superior Title in Anesthesiology (TSA); Master in Neuroscience, Universidade Federal de Pernambuco, Recife; Coordinator, IMIP, Recife, PE, Brazil. Electronic address: taniacouceiro@yahoo.com.br.
authors.forename: Tânia Cursino de Menezes
authors.initials: TC
authors.lastname: Couceiro
authors.affiliation: PhD in Anesthesiology, Universidade Estadual Paulista Júlio de Mesquita Filho, São Paulo; Professor & Coordinator, Faculdade Pernambucana de Saúde, Recife, PE, Brazil.
authors.forename: Luciana Cavalcanti
authors.initials: LC
authors.lastname: Lima
authors.affiliation: Resident, IMIP, Recife, PE, Brazil.
authors.forename: Fernanda Lobo Lago
authors.initials: FL
authors.lastname: Flores
authors.affiliation: TSA; MD, Assistant Physician of Ministry of Health Hospitals, Brazil.
authors.forename: Eusa Maria Belarmino
authors.initials: EM
authors.lastname: Alcoforado
authors.affiliation: TSA; Anesthesiologist.
authors.forename: Roberto de Oliveira Couceiro
authors.initials: Rde O
authors.lastname: Filho
mesh_terms: D059787:Acute Pain / Q000453:epidemiology*; D000328:Adult; D058443:Catastrophization / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D009321:Natural Childbirth; D010502:Perineum; D011247:Pregnancy
keywords: Acute Pain; Catastrophization; Natural Childbirth; Obstetric Surgical Procedures; Pain Measurement; Perineum.