1 in 4 women have chronic pain three months after cesarean delivery

  • Borges NC & al.
  • PLoS One
  • 01.01.2020

  • von Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • 1 in 4 women who undergo cesarean delivery will develop chronic postsurgical pain (CPSP).
  • Smokers, those with presurgery anxiety, and those with severe pain soon after surgery are at highest risk.

Why this matters

  • Although CPSP is common after a cesarean delivery, this is the first study to identify factors that place patients at higher risk, all of which could be minimized with preventive strategies.

Study design

  • Prospective cohort study.
  • 621 pregnant patients who underwent elective cesarean delivery.
  • Funding: Fundação de Amparo à Pesquisa do Estado de Goiás.

Key results

  • After hospital discharge, simple analgesics or NSAIDs used for pain relief:
    • 95.8% at 7 days of surgery.
    • 36.0% at 30 days after surgery.
    • 15.5% at 60 days after surgery.
    • 17.0% at 90 days after surgery.
  • No patients used an opioid after hospital discharge.
  • At 3 months postsurgery, incidence of CPSP was 25.5% (95% CI, 21.8%-29.7%), most moderate to severe.
  • After multivariable analysis, independent risk factors (adjusted relative risks; 95% CIs) for CPSP:
    • Smoking: 2.22 (1.27-3.88).
    • Preoperative anxiety: 1.03 (1.00-1.05). 
    • Severe postsurgical pain 7 days after surgery: 2.79 (1.29-6.00).

Limitations

  • Single-center study (Brazil).