title: Risk factors for persistent pain and its influence on maternal wellbeing after cesarean section.
abstract: OBJECTIVE
  To investigate the overall incidence and risk factors for persistent pain and its interference with daily life after cesarean section.
  
  
  METHODS
  Prospective long-term follow-up study.
  
  
  METHODS
  Karolinska University Hospital, Stockholm, Sweden.
  
  
  METHODS
  260 healthy women who underwent elective cesarean section.
  
  
  METHODS
  Information on demographics, medical history, postoperative pain and analgesic requirements was collected. A questionnaire consisting of the Brief Pain Inventory was posted at 3, 6 and 12 months after surgery. Women rated pain intensity as well as interference with factors related to general function and quality of life.
  
  
  METHODS
  The overall incidence and risk factors for persistent postoperative pain at three time points. Persistent pain was considered a secondary outcome.
  
  
  RESULTS
  At 3, 6 and 12 months respectively 40, 27 and 22% of patients reported pain in one or more locations, in the surgical site as well as in other areas. A psychological indication, as well as a first cesarean section, increased the risk for pain at 3 months. Severe postoperative pain in the immediate postoperative period or undergoing a first cesarean section were significant independent risk factors for the development of persistent pain up to 6 months after cesarean section. Parameters related to quality of life were significantly impaired in women with persistent pain.
  
  
  CONCLUSIONS
  Several factors, including severe postoperative pain, were shown to influence the risk for persistent pain after cesarean section. Long-term pain markedly affected women's wellbeing.
authors.affiliation: Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Obstetrics and Gynecology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.|Sophiahemmet University, Stockholm, Sweden.
authors.forename: Boel
authors.initials: B
authors.lastname: Niklasson
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Georgsson Öhman
authors.affiliation: Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Märta
authors.initials: M
authors.lastname: Segerdahl
authors.affiliation: Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Obstetrics and Gynecology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Agneta
authors.initials: A
authors.lastname: Blanck
mesh_terms: D000328:Adult; D002585:Cesarean Section; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology* / Q000523:psychology*; D011247:Pregnancy; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology
keywords: Cesarean section; persistent pain; postoperative pain; quality of life; risk factors