Objectives: To investigate the overall incidence and risk factors for persistent pain and its interference with daily life after cesarean section.
Design: Prospective long-term follow-up study.
Setting: Karolinska University Hospital, Stockholm, Sweden.
Population: 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.
Main outcome measures: 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.
Conclusion: 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.
Keywords: Cesarean section; persistent pain; postoperative pain; quality of life; risk factors.
© 2015 Nordic Federation of Societies of Obstetrics and Gynecology.