title: Influence of body posture on the association between postpartum depression and pain.
abstract: OBJECTIVE
  To determine the association between postpartum depression (PPD), intensification of back pain and exacerbation of changes in postural alignment intrinsic to puerperium.
  
  
  METHODS
  Eighty women at 2 to 30 weeks postpartum were included in the study according to the following criteria: literate mothers, gestation of 34 to 42 weeks, and healthy live-born infants. All mothers agreed to participate in the study. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Pain was assessed using a visual analogue scale (VAS) and the Nordic Musculoskeletal Questionnaire (NMQ), and posture, using real time naturalistic observation.
  
  
  RESULTS
  There was a statistically significant association between PPD and pain intensity (p = 0.002). The upper back was the most frequent pain site among depressed women, both before (p = 0.04) and after delivery (p = 0.01). There were no associations between PPD and type of posture (p = 0.328). However, pain intensity was greater among depressed women in the swayback group (p < 0.001).
  
  
  CONCLUSIONS
  The intensification of puerperal pain is closely associated with PPD. Our results suggest that back pain may be both a risk factor and a comorbidity of PPD among puerperal women and that pain and type of posture are interdependent.
authors.affiliation: Department of Physical Therapy, Universidade de Pernambuco, Petrolina, PE, Brazil.
authors.forename: Rita di Cássia de Oliveira
authors.initials: Rd
authors.lastname: Angelo
authors.affiliation: UPE, Petrolina, PE, Brazil.
authors.forename: Denila Coelho da
authors.initials: DC
authors.lastname: Silva
authors.affiliation: UFPE, Recife, PE, Brazil.
authors.forename: Carla Fonseca
authors.initials: CF
authors.lastname: Zambaldi
authors.affiliation: Department of Neuropsychiatry, UFPE, Recife, PE, Brazil.
authors.forename: Amaury
authors.initials: A
authors.lastname: Cantilino
authors.affiliation: Department of Neuropsychiatry, UFPE, Recife, PE, Brazil.
authors.forename: Everton Botelho
authors.initials: EB
authors.lastname: Sougey